Abstract

Diagnostic colonoscopy is considered a safe procedure. In teaching hospitals, perforations occur with a frequency of 0.14% to 0.26%. 1 Habr-Gama A Waye JD Complications and hazards of gastrointestinal endoscopy. World J Surg. 1989; 13: 193-201 Crossref PubMed Scopus (136) Google Scholar , 2 Frühmorgen P Demling L Complications of diagnostic and therapeutic colonoscopy in the Federal Republic of Germany. Results of an inquiry. Endoscopy. 1979; 2: 146-150 Crossref Scopus (151) Google Scholar , 3 Smith LF Symposium. Fiberoptic colonoscopy: complications of colonoscopy and polypectomy. Dis Colon Rectum. 1976; 19: 407-412 Crossref PubMed Scopus (156) Google Scholar Most of these adverse events occur during the learning period and are apparently related to the use of too much force during instrument insertion or rotating and straightening maneuvers. They have rarely been encountered at insertion of splinting and biopsy devices and are probably altogether avoidable if such instruments are slowly advanced under direct vision. However, taking all of these precautions into consideration, one of the authors (VFE) recently experienced his first perforation due to procurement of a mucosal biopsy specimen after more then 10,000 diagnostic colonoscopies.

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