| 대장내시경술 시행 중 발생한 대장천공의 치료 |
| 남궁환·조문경*·이강홍*·명승재†·양석균†·유창식*·김희철*·김진천* |
| 단국대학교 의과대학 외과학교실, 울산대학교 의과대학 *외과학교실, †내과학교실 및 서울아산병원 대장항문클리닉 |
| Management of Colonic Perforation during Colonoscopic Procedure |
| Hwan Namgung, M.D., Moon Kyung Cho, M.D.*, Kang Hong Lee, M.D.*, Seung Jae Myung, M.D.†, Suk Kyun Yang, M.D.†, Chang Sik Yu, M.D.*, Hee Cheol Kim, M.D.* and Jin Cheon Kim, M.D.* |
| Department of Surgery, University of Dankook College of Medicine, Cheonan, Departments of *Surgery and †Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea |
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| Abstract |
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Background/Aims:
Colonic perforation appears to be the most dangerous complication during colonoscopy. This study was designed to determine the optimal management for this infrequent accident.
Methods:
We reviewed the medical records of 17,510 colonoscopies which were performed during recent one-year period and found eight colonic perforations (0.05%).
Results:
Six perforations (0.04%) related to 16,695 diagnostic procedures, whereas two (0.25%) occurred from therapeutic procedures (p=0.05). Operative measures were applied in six (75.0%) patients showing signs of peritonitis. Five patients received primary closure without diversion, and resection with primary anastomosis was performed in one patient who had underlying tuberculous colitis. In addition, one patient was treated conservatively with bowel rest and intravenous antibiotics. Endoscopic clipping was applied in one patient with rectal perforation. Seven patients recovered uneventfully, and one 69-year-old male patient died of cardiogenic shock after the operation.
Conclusions:
Although colonic perforation occurs infrequently during colonoscopy, it may sometimes results in a fatal outcome. Primary closure without diversion appears to be appropriate in most cases without comorbid colonic disease. (Korean J Gastrointest Endosc 2005;30:188193) |
| Key Words:
Management, Colonoscopy, Colon, Perforation |
| 주요어:
치료, 대장내시경술, 대장, 천공 |
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