2016 Volume 69 Issue 4 Pages 210-215
According to a national survey by the Japan Gastroenterological Endoscopy Society, the rate of accidental complications with colonoscopy is reported to be 0.078%. In the case of perforation by colonoscopy, generally an emergency operation is performed, however, laparoscopic operation or conservative treatment may be performed as a minimally invasive treatment.
The present case was a 71-year-old woman. When she underwent colonoscopy in another facility, perforation of the sigmoid colon occurred and so she was introduced to our institution. Upon CT scan, a large quantity of retroperitoneum emphysemas around the inferior vena cava, aorta, and the right kidney, and a mediastinum emphysema near the esophagus were found.
Because the abdominal pain was slight and abnormality of the inflammatory reaction by blood test was not recognized, we chose conservative treatment. The condition and the emphysema gradually improved, and she was discharged after one month. There have been few reports on conservative treatment for iatrogenic colonic perforation, and recovery following conservative treatment with widespread air leaks is rare. It is suggested that operation can be avoided in more cases through close observation.
