Laparoscopy in iatrogenic colonoscopic perforation: A case report and literature review

Abstract

Bowel cancer incidence has been increasing worldwide. It is the fourth most common cancer among men and the third most common among women. Screening test like Faecal Occult Blood Test (FOBT) and Colonoscopy are particularly important for early detection of asymptomatic bowel cancer. Although colonoscopy is almost always safe but complications may occur. Most complications are mild and self-resolving, such as abdominal and anal pain, flatulence, and diarrhoea. The most serious complication of colonoscopy is iatrogenic colonoscopic perforation. The overall reported incidence of perforation ranges from 0.1–0.3% for diagnostic colonoscopy and from 0.4–1.0% for therapeutic colonoscopy. Since its first introduction in 1969, colonoscopy is considered the gold standard method for the diagnosis, treatment, and follow-up of colorectal cancer. Hereby, presenting a case study of an 83-year-old man, who had iatrogenic colonoscopic perforation post elective colonoscopy, which was successfully managed laparoscopically. Laparoscopic treatment seems to reduce the invasiveness and morbidity of major surgery. At the same time, it is more definitive than conservative treatment. Therefore, use of laparoscopic techniques have become the preferred method to treat colonoscopy related colonic perforations. Since colonoscopic perforations are rare, the management of this complication by laparoscopic procedure is poorly defined. By presenting this case study and review of literatures we would like to demonstrate that laparoscopic approach is a safe option for treatment and diagnosis of selected colonoscopic perforations.