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Review
. 2018 Jan 24:13:5.
doi: 10.1186/s13017-018-0162-9. eCollection 2018.

2017 WSES guidelines for the management of iatrogenic colonoscopy perforation

Nicola de'Angelis  1 , Salomone Di Saverio  2 , Osvaldo Chiara  3 , Massimo Sartelli  4 , Aleix Martínez-Pérez  5 , Franca Patrizi  6 , Dieter G Weber  7 , Luca Ansaloni  8 , Walter Biffl  9 , Offir Ben-Ishay  10 , Miklosh Bala  11 , Francesco Brunetti  1 , Federica Gaiani  12 , Solafah Abdalla  1 , Aurelien Amiot  13 , Hany Bahouth  10 , Giorgio Bianchi  1 , Daniel Casanova  14 , Federico Coccolini  8 , Raul Coimbra  15 , Gian Luigi de'Angelis  12 , Belinda De Simone  16 , Gustavo P Fraga  17 , Pietro Genova  18 , Rao Ivatury  19 , Jeffry L Kashuk  20 , Andrew W Kirkpatrick  21 , Yann Le Baleur  13 , Fernando Machado  22 , Gustavo M Machain  23 , Ronald V Maier  24 , Alain Chichom-Mefire  25 , Riccardo Memeo  26 , Carlos Mesquita  27 , Juan Carlos Salamea Molina  28 , Massimiliano Mutignani  29 , Ramiro Manzano-Núñez  30 , Carlos Ordoñez  30 , Andrew B Peitzman  31 , Bruno M Pereira  17 , Edoardo Picetti  32 , Michele Pisano  8 , Juan Carlos Puyana  33 , Sandro Rizoli  34 , Mohammed Siddiqui  1 , Iradj Sobhani  13 , Richard P Ten Broek  35 , Luigi Zorcolo  36 , Maria Clotilde Carra  37 , Yoram Kluger  10 , Fausto Catena  38
Affiliations
Review

2017 WSES guidelines for the management of iatrogenic colonoscopy perforation

Nicola de'Angelis et al. World J Emerg Surg. .

Abstract

Iatrogenic colonoscopy perforation (ICP) is a severe complication that can occur during both diagnostic and therapeutic procedures. Although 45-60% of ICPs are diagnosed by the endoscopist while performing the colonoscopy, many ICPs are not immediately recognized but are instead suspected on the basis of clinical signs and symptoms that occur after the endoscopic procedure. There are three main therapeutic options for ICPs: endoscopic repair, conservative therapy, and surgery. The therapeutic approach must vary based on the setting of the diagnosis (intra- or post-colonoscopy), the type of ICP, the characteristics and general status of the patient, the operator's level of experience, and surgical device availability. Although ICPs have been the focus of numerous publications, no guidelines have been created to standardize the management of ICPs. The aim of this article is to present the World Society of Emergency Surgery (WSES) guidelines for the management of ICP, which are intended to be used as a tool to promote global standards of care in case of ICP. These guidelines are not meant to substitute providers' clinical judgment for individual patients, and they may need to be modified based on the medical team's level of experience and the availability of local resources.

Keywords: Antibiotic therapy; Colonoscopy; Emergency surgery; Gastrointestinal endoscopy; Iatrogenic colonoscopy perforation; Intra-abdominal infection; Laparoscopy; Open abdomen.

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Conflict of interest statement

Not applicable.Not applicable.The authors declare that they have no competing interests.Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Location and frequency of iatrogenic colonoscopy perforation
Fig. 2
Fig. 2
Comprehensive algorithm for the management of iatrogenic colonoscopy perforation
See this image and copyright information in PMC

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