Iatrogenic perforation at colonic imaging

Abstract

Perforation remains an infrequent and almost certainly under-reported, complication of all colonic imaging modalities. Risk awareness, early diagnosis and active management of iatrogenic perforation minimizes an adverse outcome.

Computed tomographic colonography (CTC); colorectal cancer diagnosis with CTC in an Auckland population

“…It may also detect other causes for patient symptoms, either related to the bowel (such as appendicitis or diverticulitis), or non–bowel‐related ‘extracolonic’ abdominal problems . CTC is a safe procedure with a lower perforation rate compared with colonoscopy …”

CT Colonography to exclude colorectal cancer in symptomatic patients

“…CT Colonography (CTC) is an attractive alternative to colonoscopy in symptomatic patients. It has equivalent accuracy, potentially visualises more of the bowel mucosa [4,5], is minimally invasive with no requirement of sedation and carries a low risk of procedure-related complications [6,7]. In addition, 10%-29% of CTC will identify therapeutically significant extracolonic lesions [8,9].…”

Computed Tomographic and Magnetic Resonance Colonography: Challenge for Colonoscopy

“…Nonetheless, CT colonography is likely to be safe. Air insufflation has been associated with a very small risk of perforation; the reported risk in large series of patients appears to be approximately 1 in 2,000 [42,43,44]. It should be emphasized that perforations occurring with CT colonography are most common in patients with underlying colon abnormalities, such as those with inflammatory bowel disease, ulcerations, cancers, or other lesions that affect the integrity of the colonic mucosa and which may tear if stressed.…”