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 N1Di Saverio S2Chiara O3Sartelli M4Martínez-Pérez A5Patrizi F6Weber DG7Ansaloni L8Biffl W9Ben-Ishay O10Bala M11Brunetti F1Gaiani F12Abdalla S1Amiot A13Bahouth H10Bianchi G1Casanova D14Coccolini F8Coimbra R15de\’Angelis GL12De Simone B16Fraga GP17Genova P18Ivatury R19Kashuk JL20Kirkpatrick AW21Le Baleur Y13Machado F22Machain GM23Maier RV24Chichom-Mefire A25Memeo R26Mesquita C27Salamea Molina JC28Mutignani M29Manzano-Núñez R30Ordoñez C30Peitzman AB31Pereira BM17Picetti E32Pisano M8Puyana JC33Rizoli S34Siddiqui M1Sobhani I13Ten Broek RP35Zorcolo L36Carra MC37Kluger Y10Catena F38

World J Emerg Surg. 2018