Abstract
to evaluate the incidence, epidemiological characteristics, diagnosis and evolution of patients who returned to the emergency care units of the Albert Einstein Hospital in São Paulo/SP with signs and symptoms suggestive of colonoscopy complications up to 30 days after the procedure. we conducted a retrospective, uni-institutional study of patients submitted to colonoscopy in 2014 who returned to the Emergency department (ED) within 30 days after the procedure. 8968 patients underwent colonoscopies, 95 (1.06%) of whom had complaints related to possible complications. Most of the procedures were elective ones. Minor complications (nonspecific abdominal pain/distension) were frequent (0.49%) and most of the patients were discharged after consultation at the ED. Severe complications were less frequent: perforation (0.033%), lower gastrointestinal bleeding (0.044%), and intestinal obstruction (0.044%). ED consultations in less than 24 hours after the procedure was associated with a higher index of normal colonoscopies (p=0.006), more diagnosis of fever (p=0.0003) and dyspeptic syndrome (p=0.043), and less diagnosis of colitis/ileitis (p=0.015). The observation of fever in patients treated at the ED was associated with the diagnosis of polyps at colonoscopy (p=0.030). the data corroborate the safety of the colonoscopy exam and points to a reduction in major complications rates.
Highlights
Colonoscopy is a diagnostic and therapeutic tool that allows examination and treatment of the rectum, colon, and distal ileum
We described categorical variables by absolute frequencies and percentages, and the numerical ones by mean and standard deviation (SD) or median and quartiles, in addition to minimum and maximum values
The present study main findings were: the rate of colonoscopy-related complications that presented in the Emergency department (ED) in up to 30 days after the procedure was 1.06%
Summary
Colonoscopy is a diagnostic and therapeutic tool that allows examination and treatment of the rectum, colon, and distal ileum. Even when performed under ideal conditions, complications may occur. These complications can vary from mild discomfort and pain to death. The complications of colonoscopy cover a wide spectrum of situations, including the clinical conditions of the patient, medication use, conditions of the equipment and of the exam environment, training of the endoscopist and type of procedure performed. Such complications may be due to intestinal preparation, perforation, bleeding, mesentery lesion, extracolic organ lesions, cardiovascular complications and infection
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