Bleeding and Perforation After Outpatient Colonoscopy and Their Risk Factors in Usual Clinical Practice

Rabeneck, Linda; Paszat, Lawrence; Hilsden, Robert J.; Saskin, Refik; Leddin, Des; Grunfeld, Eva; Wai, Elaine S.; Goldwasser, Meredith A.; Sutradhar, Rinku; Stukel, Thérèse A.

doi:10.1053/j.gastro.2008.08.058

Cited by 446 publications

(358 citation statements)

References 17 publications

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“…No deaths were recorded in our series. Mortality from colonoscopy has been reported to be as high as 0.07% (1 death every 1500 colonoscopies) [41] though the rate is much lower when colonoscopy is used for screening purposes [42]. Our data on perforations is similar to that reported by the American survey [20,21] and favorably compares with the data from the survey performed in UK and Israel [18,19].…”

Section: Discussionsupporting

confidence: 83%

“…When comparing our data with the endoscopic series, the perforation rate at colonoscopy, whether diagnostic or therapeutic, would appear to be higher than that of CTC. The reported perforation rates for colonoscopy range from one case in 3115 procedures (0.032%) to one case in 510 procedures (0.196%) [17,[39][40][41][42][43][44]. Thus, our 0.02% estimate of post-CT colonography perforations imparts a significantly more favorable profile for CTC compared to colonoscopy.…”

Section: Discussionmentioning

confidence: 96%

See 1 more Smart Citation

Adverse events of computed tomography colonography: An Italian National Survey

Iafrate¹,

Iussich²,

Correale³

et al. 2013

Digestive and Liver Disease

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a b s t r a c tAim: To retrospectively study the frequency and magnitude of complications associated with computed tomography (CT) colonography in clinical practice. Methods: A questionnaire on complications of CT colonography was sent to Italian public radiology departments identified as practicing CT colonography with a reasonable level of training. The frequency of complications and possible risk factors were retrospectively determined. Responses were collated and row frequencies determined. A multivariate analysis of the factors causing adverse events was also performed. Results: 40,121 examinations were performed in13 centers during the study period. No deaths were reported. Bowel perforations occurred in 0.02% (7 exams). All perforations were asymptomatic and occurred in patients undergoing manual insufflation. Five perforations (71%) occurred in procedures performed following a recent colonoscopy. There was no significant difference between perforations associated with rectal balloon (0.017%) and those that were not (0.02%). Complications related to vasovagal reaction (either with or without spasmolytic) occurred in 0.16% (63 exams). All vasovagal reactions resolved in less than 3 h, without any sequelae. Conclusions: Perforation rate at CT colonography in Italy is comparable with elsewhere in the world, occurring regardless of the experience of radiology centers. Although the risk is very small, it may not be negligible when compared with the risk of diagnostic colonoscopy.

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Section: Discussionsupporting

confidence: 83%

Section: Discussionmentioning

confidence: 96%

Adverse events of computed tomography colonography: An Italian National Survey

Iafrate¹,

Iussich²,

Correale³

et al. 2013

Digestive and Liver Disease

View full text Add to dashboard Cite

show abstract

“…The risk factors for colonoscopy-related perforation were older age, increased comorbidity score, polypectomy, and low-volume endoscopists (when perforation combined with bleeding) [23]. However, this finding was different from a study by Wexner which showed neither an absolute number of prior colonoscopies, nor any ongoing annual experi-ence affected the serious complication rates [5].…”

Section: Perforationmentioning

confidence: 67%

“…The independent risk factors for colonoscopy-related bleeding were older age, male gender, polypectomy, and low-volume endoscopists [23].…”

Section: Bleedingmentioning

confidence: 99%

Complications of Colonoscopy

Waye

Aisenberg

Rubin

2013

Practical Colonoscopy

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“…The patient was discharged home 5 days later free of symptoms. Colonoscopy is a relatively safe procedure, and the most common complications such as bleeding and perforation are rare [1]. In our patient, excessive intraluminal pressure on the sigmoid colon caused by insertion of the colonoscope may have led to injury of intramural vessels.…”

mentioning

confidence: 72%

Acute colonic intramural hematoma: a rare complication of colonoscopy

et al. 2014

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Acute colonic intramural hematoma: a rare complication of colonoscopyA 74-year-old man with a medical history of chronic renal failure and congestive heart failure underwent diagnostic colonoscopy following a positive fecal occult blood test. He was given oral antiplatelet medications including aspirin (100 mg/ day) and sarpogrelate hydrochloride (100 mg/day), which were stopped 5 days before colonoscopy. During the procedure, difficulty was encountered in reaching the ileocecal valve because of a redundant tortuous sigmoid colon, and the procedure took approximately 1 hour.On withdrawal of the colonoscope, a bright-red, hyperemic, elevated mass with some oozing blood was identified in the sigmoid colon, although no abnormalities had been detected on insertion. The colonic lumen was occupied by the mass, the surface of which was smooth and covered with normal colonic mucosa (• " Fig. 1). Urgent abdominal computed tomography (CT) showed a soft tissue mass of the sigmoid colon with a density suggesting blood (• " Fig. 2). There was no evidence of free air. On the basis of these findings, a diagnosis of colonic intramural hematoma was made. As the patient's condition was stable, he was treated conservatively with observation. Three days later, follow-up colonoscopy showed that the hematoma had ruptured and disappeared, having reverted spontaneously back to flat mucosa (• " Fig. 3). The patient was discharged home 5 days later free of symptoms. Colonoscopy is a relatively safe procedure, and the most common complications such as bleeding and perforation are rare [1]. In our patient, excessive intraluminal pressure on the sigmoid colon caused by insertion of the colonoscope may have led to injury of intramural vessels.Colonic intramural hematoma is an extremely rare complication of diagnostic colonoscopy and has been described in only two cases [2,3], both of which were detected by CT within the first 12 hours after colonoscopy. To the best of our knowledge, ours is the first case diagnosed as colonic intramural hematoma during colonoscopy. Endoscopy_UCTN_Code_CPL_1AJ_2ABCompeting interests: None Cases and Techniques Library (CTL) E180Katsurahara Masaki et al. Acute colonic intramural hematoma: a rare complication of colonoscopy … Endoscopy 2014; 46: E180-E181This document was downloaded for personal use only. Unauthorized distribution is strictly prohibited.

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Bleeding and Perforation After Outpatient Colonoscopy and Their Risk Factors in Usual Clinical Practice

Cited by 446 publications

References 17 publications

Adverse events of computed tomography colonography: An Italian National Survey

Adverse events of computed tomography colonography: An Italian National Survey

Complications of Colonoscopy

Acute colonic intramural hematoma: a rare complication of colonoscopy

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