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대장내시경 천공의 치료로서 보존적 치료의 안전성

Safety of Conservative Treatment of Colonoscopic Perforation

대한대장항문학회지 2005년 21권 6호 p.384 ~ 389
나은종 ( Na Eun-Jong ) - 조선대학교 의과대학 외과학교실

김경종 ( Kim Kyung-Jong ) - 조선대학교 의과대학 외과학교실
민영돈 ( Min Young-Don ) - 조선대학교 의과대학 외과학교실

Abstract


Purpose: Colonoscopy is a relatively safe procedure. However, various complications, such as hemorrhage or perforation, can occur, and among them, perforation can lead to death. This study was designed to evaluate the clinical characteristics and the treatment of colonoscopic perforation, as well as the availability of conservative treatment as the initial management.

Methods: We reviewed the medical records of the 11 patients who had been treated for colonoscopic perforation from May 2003 to April 2005.

Results: Six perforations were related to diagnostic colonoscopy whereas five occurred from therapeutic colonoscopy. The sigmoid colon was the most common perforation site (6 patients), followed by the cecum 2 patients and the transverse colon, splenic flexure, and the rectum 1 patient each. Five patients were diagnosed during colonoscopy. Six patients were diagnosed 12∼48 hours after the colonoscopy. Three patients who showed definite signs of peritonitis underwent emergency operations. A conservative treatment was done in eight patients; among them, one patient had an operation on the 3rd. day after the perforation. The remaining seven patients underwent conservative treatment and were followed for up to 1 month without complications. Among these patients, one patient had a recurrent perforation on the 33rd day after the initial perforation, and an operation was done.

Conclusions: These results suggest that conservative treatment in patients with colon perforations is safe and effective unless there are obvious signs of generalized peritonitis. J Korean Soc Coloproctol 2005;21:384-389

키워드

대장내시경 천공;보존적 치료
Colonoscopic perforation;Conservative treatment
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