Abstract
Colonoscopy is increasingly utilized for colorectal cancer screening, diagnosis of colorectal pathologies and therapeutic interventions for benign and malignant conditions. Perforation is a rare but morbid complication of colonoscopy. Management of colonoscopic perforation has evolved in parallel with advances in minimally invasive techniques to include nonoperative, endoscopic, and laparoscopic options. Endoscopic management has high success rates for select patients with small perforations diagnosed at the time of colonoscopy. Laparoscopic repair is associated with significantly decreased complications and hospital length of stay (LOS) compared to open repair. Smaller perforations diagnosed at the time of colonoscopy may be managed with endoscopic repair, while larger perforations or failed endoscopic repair should be managed with laparoscopy. Delayed presentation of colonoscopic perforation with fecal spillage or hemodynamic instability continue to warrant laparotomy.
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