EP.FRI.978 Colonoscopy perforation: A single centre experience

Aims Colonic perforation is an adverse event of colonoscopy. This is around 1/1500 in diagnostic colonoscopy, 1/500 in polypectomy procedures & 1/50 in EMR procedure. This study is to evaluate the management of colonic perforation at a single centre. Methods Colonoscopy carried out on patients with colorectal cancer symptoms, family history, colorectal cancer & polyp surveillance. Retrospective study carried out since 2012 on all colonoscopies with evaluation of colonoscopy perforation. Conclusion 7 colonoscopy perforations encountered over 8 years, with incidence of 0.03 - 0.06 % per year. Surgery undertaken in 5 cases with concomitant disease bowel (2 IBD’s & 3 diverticulitis). 2 cases of conservative management. Surgical resection of diseased bowel occurred in 4 cases with 4 cases of diversion stoma. One case of diversion stoma was subsequently reversed, whilst other 2 case were deemed medically unfit. Colonoscopy is carried out by JAG accredited endoscopists. Colonic perforation during colonoscopy is increased in: polypectomy (right colonic), therapeutic EMR, diseased bowel (IBD, diverticular disease), challenging colons. Management of colonoscopy perforation should individualized with early clinical & radiological diagnosis.

Post colonoscopy colonic perforation with parietal abscess: a rare case report

Colonoscopy is a common method of diagnosing colon and rectum illnesses. Complications from colonoscopy are rare. However, perforation is one of the most common problems observed. The incidence is 0.005-0.085 percent. Extraperitoneal and mixed postcolonoscopy colonic perforations are classified as intraperitoneal, extraperitoneal and both combined. Extraperitoneal perforation is rare and frequently accompanied with subcutaneous emphysema and retroperitoneal abscess. Contrast CT scan is the most effective diagnostic and therapy tool. A parietal abscess after colonoscopy is quite rare. Only one incidence of post-colonoscopy retroperitoneal colonic perforation with parietal abscess has been reported. An unusual case of colonic perforation after diagnostic colonoscopy was presented with a parietal abscess on the left iliac area. The patient, a 63-year-old diabetic male, had a diagnostic colonoscopy for intestinal irregularity. Afternoon severe ache over left iliac region brought patient to doctor. Nothing notable was discovered. So, they prescribed symptomatic drugs. Symptomatic medications were prescribed but without any relief. An abdominal contrast CT was recommended to him by his doctor after a few days. This retro muscular accumulation in the left transverses abdominis muscle communicated with the sigmoid colon. No signs of peritonitis or septicemia. Patient was stable. The aspirated fluid was sent for culture and sensitivity testing, and intravenous hydration and antibiotics were commenced. Patient tolerated conservative care. The subject was discharged in 2 weeks. Diagnosis and treatment of perforation are critical to recovery.