| [ Summary ] |
In cases where there is diffuse peritonitis following colonoscopic perforation, emergency operations must be performed. Given short duration after perforation, minimal contamination of the abdominal organs, reliable confirmation of perforation sites, and feasibility of pneumoperitoneum, laparoscopic approaches can be considered. When those measures are not possible, open surgery should be done. Based on the patientʼs condition, an immediate reconstruction of the bowel after resection of the perforated bowel or bowel wall, or construction of a stoma should be performed. Antibiotic therapy, peritoneal lavage, and abdominal drainage are always necessary. When there is no diffuse peritonitis, and given that the perforation has been successfully closed by clipping or given that there is a long time between colonoscopy and perforation, conservative treatment can be employed. During conservative treatment, we must always be cautious not to overlook a deterioration of the patientʼs condition. |