The growing endoscopic activity, both diagnostic and therapeutic, are also globally makes frequent endoscopic complications, perforation being one of the most serious. However, we also have more possibilities for endoscopic resolution of iatrogenic caused. We report the case of a sigmoid perforation during a colonoscopy that was resolved satisfactorily, avoiding surgery, by endoscopic closure with a nitinol clip Ovesco ® . CASE REPORTAn 82-year-old woman was admitted for assessment of iron deficiency after an episode of syncope. She had a surgical history of hiatal hernia repair 20 years earlier (which subsequently relapsed) and hysterectomy. Tumour markers were normal. Gastroscopy confirmed the presence of a hiatal hernia. Colonoscopy under deep sedation with propofol only and CO 2 insufflation revealed no abnormalities in the explored colonic segment. After traversing about 25 cm of the fixed sigmoid colon with difficulty, an iatrogenic perforation occurred. The perforation was immediately noticed and the endoscope was withdrawn, revealing an approximately 12 mm hole 18 cm distal to the anal margin, through which omentum could be seen (Fig. 1) CLINICAL NOTEDíez-Redondo P, Blanco JI, Lorenzo-Pelayo S, de la SernaHiguera C, Gil-Simón P, Alcaide-Suárez N, Pérez-Miranda M. A novel system for endoscopic closure of iatrogenic colon perforations using the Ovesco® clip and omental patch. Rev Esp Enferm Dig 2012;104:550-552. Fig. 1. Endoscopic image of colonic wall perforation, through which an epiploic appendix is visible.

Unusual cases and technical notes E274 Alcaide N et al. Sigmoid perforation caused by a migrated biliary stent … Endoscopy 2012; 44: E274

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