Endoscopic treatment of delayed colon perforation: the enteroscopy overtube approach

Abstract

Background and study aims: Delayed perforation is a rare complication of therapeutic colonoscopy, and it is severe and sometimes lethal. This paper reports on a new minimally invasive method for the treatment of delayed colonic perforation.

Patients and methods: Three patients with delayed colonic perforation underwent the therapy, which involved three steps: (1) closure with endoclips and loop, (2) overtube placement, and (3) antibiotic wash through a nasobiliary tube.

Results: The procedure was successful in all three patients and no recurrence was observed during 5 - 41 months of follow-up.

Conclusions: Although this study involved only a small number of patients and no control arm, the method involving an overtube appears to be a feasible and effective endoscopic treatment for delayed colonic perforation.