Management of bleeding and perforation after colonoscopy

Expert Rev Gastroenterol Hepatol. 2014 Nov;8(8):963-72. doi: 10.1586/17474124.2014.925797. Epub 2014 May 31.

Abstract

Bleeding is a relatively rare complication occurring mainly after snare polypectomy. The majority of cases can be managed successfully by endoscopic means leaving very few cases which will ultimately need an operation. Colonic perforation, on the other hand is a serious complication that requires intensive and careful management. Prompt recognition of the perforation during the procedure allows, in selected cases, immediate endoscopic closure with an uneventful and full recovery followed by close monitoring and surgical management in case of clinical deterioration. The criteria for the right selection of perforation cases amenable to endoscopic treatment do still need to be confirmed by prospective studies and further experience is required before a standard algorithm on the endoscopic management of perforations is developed.

Keywords: colonoscopy complication; endoscopic closure; perforation; postpolypectomy bleeding.

Publication types

  • Review

MeSH terms

  • Colonoscopy / adverse effects*
  • Gastrointestinal Hemorrhage / diagnosis
  • Gastrointestinal Hemorrhage / etiology
  • Gastrointestinal Hemorrhage / therapy*
  • Hemostatic Techniques
  • Humans
  • Intestinal Perforation / diagnosis
  • Intestinal Perforation / etiology*
  • Intestinal Perforation / therapy*
  • Postoperative Hemorrhage / diagnosis
  • Postoperative Hemorrhage / etiology*
  • Postoperative Hemorrhage / therapy*
  • Risk Assessment