A Case of Iatrogenic Colonic Perforation Treated by Clipping and Preventing Surgery

Abstract

The patient was a 77-year-old male with previous history of surgery (low anterior resection) due to a rectal carcinoma in October 1996. During endoscopic follow-up examination performed in December 1997, insertion of the sliding tube produced a perforation of the colon at approximately 20 cm from the anus. No symptoms were referred by the patient and the perforation was sutured with hemoclips. Abdominal X-ray taken immediately after the procedure showed no free air in the abdomen.
The patient was hospitalized and treated conservatively with total parenteral nutrition and antibiotic therapy. The slight abdominal pain disappeared 10 days later. Endoscopic follow-up 2 weeks later showed the perforated area changed to an ulcer coated with fibrin. Oral diet was then started and the patient was discharged 1 week later.
We report a case in which suturing with hemoclips showed to be useful for the treatment of an iatrogenic colonic perforation.