Endoscopic treatment of delayed colon perforation: the enteroscopy overtube approach

Endoscopy. 2014 Jun;46(6):503-8. doi: 10.1055/s-0034-1365040. Epub 2014 Apr 28.

Abstract

Background and study aims: Delayed perforation is a rare complication of therapeutic colonoscopy, and it is severe and sometimes lethal. This paper reports on a new minimally invasive method for the treatment of delayed colonic perforation.

Patients and methods: Three patients with delayed colonic perforation underwent the therapy, which involved three steps: (1) closure with endoclips and loop, (2) overtube placement, and (3) antibiotic wash through a nasobiliary tube.

Results: The procedure was successful in all three patients and no recurrence was observed during 5 - 41 months of follow-up.

Conclusions: Although this study involved only a small number of patients and no control arm, the method involving an overtube appears to be a feasible and effective endoscopic treatment for delayed colonic perforation.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Anti-Infective Agents / administration & dosage
  • Colonoscopy / adverse effects
  • Colonoscopy / instrumentation
  • Colonoscopy / methods*
  • Dissection / adverse effects
  • Female
  • Humans
  • Intestinal Mucosa / surgery
  • Intestinal Perforation / etiology
  • Intestinal Perforation / therapy*
  • Male
  • Metronidazole / administration & dosage
  • Middle Aged
  • Therapeutic Irrigation*
  • Time Factors

Substances

  • Anti-Infective Agents
  • Metronidazole