[Surgery for complications resulting from para-clinical colorectal examinations]

Abstract

Colo-rectal perforations during barium enema are exceptional, but very serious. They give rise to a retro- or intra-peritoneal septic barioma. Despite its emergency treatment, the peritonitis remains very severe (50% mortality) and peritoneal toilet is difficult. Peri-visceral complications are also possible. Perforations during diagnostic colonoscopy are less serious, as they occur in a prepared colon. When operated immediately, the mortality is less than 20%. The greatest risk consists of overlooking the initial accident and only reviewing the patient at a late stage. In this case, the mortality is similar to that of the radiological perforations. Perforations during polypectomy are generally small or simple fissures and are less often surgical. Severe haemorrhages requiring a surgical operation are exceptional. All of these complications tend to disappear when certain technical rules are respected and with increasing operator experience.