Laparoscopic treatment of a sigmoid perforation after colonoscopy

Abstract

The authors report a case of sigmoid colon perforation post colonoscopic polypectomy. Such perforation is rare and has been estimated to occur between 0.1 and 3% of the time. Surgical treatment is necessary when there is deterioration of the clinical state. In this reported case, surgical closure of the perforation was achieved by laparoscopy. We believe that this approach is effective for colonic suture, peritoneal lavage, and drainage.

Laparoscopic repair of colon perforation after colonoscopy in children: report of 2 cases and review of the literature

“…The traditional approach was a laparotomy with either primary repair or diverting colostomy. There have been several reports of laparoscopic repair of perforations after colonoscopy in adults [1][2][3][4][5][6][7][8][9][10][11][12] and some reports of nonoperative management [13][14][15]. We present 2 children with colonic perforation after colonoscopic polypectomy who were treated successfully by laparoscopy.…”

“…Although patients with mild symptoms and negative imaging studies could be observed, any clinical suspicion of a perforation is sufficient to justify a low threshold for operative intervention. There are several reports of successful laparoscopic repair of colon perforation after colonoscopy in adults [1][2][3][4][5][6][7][8][9][10][11][12]. Each recommends an approach consistent with traditional surgical principles such as adequate visualization, control of spillage, incorporating viable tissue in the repair, and broad-spectrum antibiotics.…”

“…In the past, all injuries of the colon were treated with laparotomy and either primary repair or diverting colostomy, depending on the degree of peritoneal soiling, the time interval between injury and diagnosis, and comorbidities of the patient. Several reports of laparoscopic repair in adults have been published [1][2][3][4][5][6][7][8][9][10][11][12]. Some have even advocated nonoperative management in selected cases [13][14][15].…”

Laparoscopic treatment of colonic perforations related to colonoscopy

“…Some case reports indicate that laparoscopic treatment of colonic perforations has been performed by suture or tangential resection. However, the two case reports of simple closure by suture do not mention about thermal damage or necrosis [6,11,12]. We would like to draw the reader's attention to the issue of thermal damage, since it can cause rupture of the suture line as well as necrosis.…”

Iatrogene Kolonperforation

“…So finden sich in der Literatur zunehmend Kasuistiken über laparoskopisch assistierte Eingriffe, Wedge-Resektionen und laparoskopische Übernä-hungen [1,2,7,10,14,15,16,20,21,22].…”