INTESTINE Vol.9 No.5(6-3)

特集名 大腸内視鏡検査のリスクマネジメント
題名 偶発症の予防と対処 (3) 腸管穿孔の手術のタイミング
発刊年月 2005年 09月
著者 浅尾 高行 群馬大学大学院医学研究科病態総合外科
著者 桑野 博行 群馬大学大学院医学研究科病態総合外科
【 要旨 】 要旨はありません。
Theme Management for the risk of colonoscopy
Title Laparoscopic operation or non-surgical treatment for iatrogenic perforation due to colonoscopy
Author Takayuki Asao Department of General Surgical Science, Gunma University
Author Hiroyuki Kuwano Department of General Surgical Science, Gunma University
[ Summary ] Endoscopic resection of large mucosal lesions has become common. Iatrogenic colonic perforations can occurr frequently during colonoscopic examinations or treatment. Minor perforations, the size of pinholes, can be repaired with conservative treatments. However, emergency operations are required for patients with increasing physical findings of peritonitis or where CT images display obvious intra-abdominal fluid, or edema in the intestine. Laparoscopy is generally feasible as long as some care is employed in irrigating the peritoneal cavity, except for patients with septic shock. Fortunately, bacterial contamination in the abdominal cavity is minimal in cases of colonoscopic perforation due to bowel irrigation performed during colonoscopy. Immediate and appropriate treatment is essential, especially in case of iatrogenic perforation due to a colonic examination or treatment.