2017 WSES guidelines for the management of iatrogenic colonoscopy perforation

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.

de\’Angelis N¹, Di Saverio S², Chiara O³, Sartelli M⁴, Martínez-Pérez A⁵, Patrizi F⁶, Weber DG⁷, Ansaloni L⁸, Biffl W⁹, Ben-Ishay O¹⁰, Bala M¹¹, Brunetti F¹, Gaiani F¹², Abdalla S¹, Amiot A¹³, Bahouth H¹⁰, Bianchi G¹, Casanova D¹⁴, Coccolini F⁸, Coimbra R¹⁵, de\’Angelis GL¹², De Simone B¹⁶, Fraga GP¹⁷, Genova P¹⁸, Ivatury R¹⁹, Kashuk JL²⁰, Kirkpatrick AW²¹, Le Baleur Y¹³, Machado F²², Machain GM²³, Maier RV²⁴, Chichom-Mefire A²⁵, Memeo R²⁶, Mesquita C²⁷, Salamea Molina JC²⁸, Mutignani M²⁹, Manzano-Núñez R³⁰, Ordoñez C³⁰, Peitzman AB³¹, Pereira BM¹⁷, Picetti E³², Pisano M⁸, Puyana JC³³, Rizoli S³⁴, Siddiqui M¹, Sobhani I¹³, Ten Broek RP³⁵, Zorcolo L³⁶, Carra MC³⁷, Kluger Y¹⁰, Catena F³⁸

World J Emerg Surg. 2018