Gastrointest Interv 2018; 7(2): 94-97  https://doi.org/10.18528/gii180023
Large-sized iatrogenic colonic perforation during diagnostic colonoscopy
Seung Yong Shin,1 Eun Jung Park,2 Jae Jun Park1,*
1Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
2Division of Colon and Rectal Surgery, Department of Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, 211 Eonju-ro, Gangnam-gu, Seoul 06273, Korea.
E-mail address: jaejpark@yuhs.ac (J.J. Park). ORCID: https://orcid.org/0000-0001-9974-1658
Received: June 26, 2018; Revised: July 16, 2018; Accepted: July 18, 2018; Published online: July 31, 2018.
© Society of Gastrointestinal Intervention. All rights reserved.

cc This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Summary of Event: A 2 cm-sized colonic perforation occurred during diagnostic colonoscopy. Endoscopic closure was performed immediately using detachable snare and conservative management with intravenous antibiotics was followed for several days. However, abdominal computed tomography showed huge abscess and its connection to the sigmoid colon. The patient underwent segmental colectomy, which revealed the incomplete closure of perforated lesion with severe serosal fibrotic change.
Teaching Point: Endoscopic treatment of large-sized colonic perforations should be undertaken with caution since the possibility of incomplete closure is high. For large-sized colonic perforations, early surgical treatment should be preferentially considered over endoscopic treatment.
Keywords: Colon; Endoscopic closure; Iatrogenic perforation; Surgical treatment


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