Clinical Gastroenterology Vol.17 No.8(2-2)

Theme Complications and their Managements for Gastrointestinal Endoscopy
Title Complications and their Managements During Diagnostic Colonoscopy
Publish Date 2002/07
Author Yoshiharu Uno Hakodate, Takahashi Hospital
[ Summary ] The most common complications during colonoscopy are perforations, hemorrhaging and vasovagal reactions. The incidence of colonic perforation was 0.02 to 0.03%. The sigmoid colon is the most common site for perforations. Perforation of the colon most often is the result of direct force from the colonoscope shaft or tip causing increased mechanical pressure. Almost all patients with perforations complained of severe abdominal pain before perforation. Perforation rarely occurs with the use of biopsy forceps and a sliding tube. The incidence of hemorrhaging as a complication was 0.014%. A vasovagal reaction may be recognized when a patient becomes cold, exhibits bradycardia or hypotension. Rare complications during colonoscopy are splenic injury, ischemic colitis, local edema, volvulus, dissection of a large aortic aneurysm, retropneumoperitoneum, pneumatosis cystoides coli, pneumothorax and subcutaneous emphysema. There is an increased incidence of complications when using a sliding tube and a rigid-shaft colonoscope.
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