World Journal of Emergency Surgery (Jan 2018)
2017 WSES guidelines for the management of iatrogenic colonoscopy perforation
- Nicola de’Angelis,
- Salomone Di Saverio,
- Osvaldo Chiara,
- Massimo Sartelli,
- Aleix Martínez-Pérez,
- Franca Patrizi,
- Dieter G. Weber,
- Luca Ansaloni,
- Walter Biffl,
- Offir Ben-Ishay,
- Miklosh Bala,
- Francesco Brunetti,
- Federica Gaiani,
- Solafah Abdalla,
- Aurelien Amiot,
- Hany Bahouth,
- Giorgio Bianchi,
- Daniel Casanova,
- Federico Coccolini,
- Raul Coimbra,
- Gian Luigi de’Angelis,
- Belinda De Simone,
- Gustavo P. Fraga,
- Pietro Genova,
- Rao Ivatury,
- Jeffry L. Kashuk,
- Andrew W. Kirkpatrick,
- Yann Le Baleur,
- Fernando Machado,
- Gustavo M. Machain,
- Ronald V. Maier,
- Alain Chichom-Mefire,
- Riccardo Memeo,
- Carlos Mesquita,
- Juan Carlos Salamea Molina,
- Massimiliano Mutignani,
- Ramiro Manzano-Núñez,
- Carlos Ordoñez,
- Andrew B. Peitzman,
- Bruno M. Pereira,
- Edoardo Picetti,
- Michele Pisano,
- Juan Carlos Puyana,
- Sandro Rizoli,
- Mohammed Siddiqui,
- Iradj Sobhani,
- Richard P. ten Broek,
- Luigi Zorcolo,
- Maria Clotilde Carra,
- Yoram Kluger,
- Fausto Catena
Affiliations
- Nicola de’Angelis
- Unit of Digestive, Hepato-Pancreato-Biliary Surgery and Liver Transplantation, Henri Mondor University Hospital, AP-HP, and University of Paris Est, UPEC
- Salomone Di Saverio
- Department of Surgery, Maggiore Hospital
- Osvaldo Chiara
- General Surgery and Trauma Team, Niguarda Hospital
- Massimo Sartelli
- Department of Surgery, Macerata Hospital
- Aleix Martínez-Pérez
- Department of General and Digestive Surgery, University Hospital Dr Peset
- Franca Patrizi
- Unit of Gastroenterology and Endoscopy, Maggiore Hospital
- Dieter G. Weber
- Department of Trauma Surgery, Royal Perth Hospital
- Luca Ansaloni
- General Surgery I, Papa Giovanni XXIII Hospital
- Walter Biffl
- Acute Care Surgery at The Queen’s Medical Center, John A. Burns School of Medicine, University of Hawaii
- Offir Ben-Ishay
- Department of General Surgery, Rambam Healthcare Campus
- Miklosh Bala
- Trauma and Acute Care Surgery Unit, Hadassah Hebrew University Medical Center
- Francesco Brunetti
- Unit of Digestive, Hepato-Pancreato-Biliary Surgery and Liver Transplantation, Henri Mondor University Hospital, AP-HP, and University of Paris Est, UPEC
- Federica Gaiani
- Gastroenterology and Endoscopy Unit, University Hospital of Parma
- Solafah Abdalla
- Unit of Digestive, Hepato-Pancreato-Biliary Surgery and Liver Transplantation, Henri Mondor University Hospital, AP-HP, and University of Paris Est, UPEC
- Aurelien Amiot
- Department of Gastroenterology and Digestive Endoscopy, Henri Mondor Hospital, AP-HP, and University of Paris Est, UPEC
- Hany Bahouth
- Department of General Surgery, Rambam Healthcare Campus
- Giorgio Bianchi
- Unit of Digestive, Hepato-Pancreato-Biliary Surgery and Liver Transplantation, Henri Mondor University Hospital, AP-HP, and University of Paris Est, UPEC
- Daniel Casanova
- Unit of Digestive Surgery and Liver Transplantation, University Hospital Marqués de Valdecilla, University of Cantabria
- Federico Coccolini
- General Surgery I, Papa Giovanni XXIII Hospital
- Raul Coimbra
- Department of Surgery, UC San Diego Health System
- Gian Luigi de’Angelis
- Gastroenterology and Endoscopy Unit, University Hospital of Parma
- Belinda De Simone
- Unit of Digestive Surgery, Cannes Hospital
- Gustavo P. Fraga
- Division of Trauma Surgery, Department of Surgery, School of Medical Sciences, University of Campinas (Unicamp)
- Pietro Genova
- Department of General and Oncological Surgery, University Hospital Paolo Giaccone
- Rao Ivatury
- Virginia Commonwealth University
- Jeffry L. Kashuk
- Assia Medical Group, Department of Surgery, Sackler School of Medicine, Tel Aviv University
- Andrew W. Kirkpatrick
- Department of Surgery, Critical Care Medicine and the Regional Trauma Service, Foothills Medical Center
- Yann Le Baleur
- Department of Gastroenterology and Digestive Endoscopy, Henri Mondor Hospital, AP-HP, and University of Paris Est, UPEC
- Fernando Machado
- Department of Emergency Surgery, Hospital de Clínicas, School of Medicine, UDELAR
- Gustavo M. Machain
- Il Cátedra de Clínica Quirúgica, Hospital de Clínicas, Facultad de Ciencias Medicas, Universidad National de Asuncion
- Ronald V. Maier
- Department of Surgery, University of Washington
- Alain Chichom-Mefire
- Department of Surgery and Obstetrics/Gynecologic, Regional Hospital
- Riccardo Memeo
- Unit of General Surgery and Liver Transplantation, Policlinico di Bari “M. Rubino”
- Carlos Mesquita
- Unit of General and Emergency Surgery, Trauma Center, Centro Hospitalar e Universitario de Coimbra
- Juan Carlos Salamea Molina
- Department of Trauma and Emergency Center, Vicente Corral Moscoso Hospital, University of Azuay
- Massimiliano Mutignani
- Digestive and Interventional Endoscopy Unit, Niguarda Ca’Granda Hospital
- Ramiro Manzano-Núñez
- Department of Surgery and Critical Care, Universidad del Valle, Fundacion Valle del Lili
- Carlos Ordoñez
- Department of Surgery and Critical Care, Universidad del Valle, Fundacion Valle del Lili
- Andrew B. Peitzman
- Department of Surgery, UPMC, University of Pittsburg, School of Medicine
- Bruno M. Pereira
- Division of Trauma Surgery, Department of Surgery, School of Medical Sciences, University of Campinas (Unicamp)
- Edoardo Picetti
- Department of Anesthesiology and Intensive Care, University Hospital of Parma
- Michele Pisano
- General Surgery I, Papa Giovanni XXIII Hospital
- Juan Carlos Puyana
- Critical Care Medicine, University of Pittsburg, School of Medicine
- Sandro Rizoli
- Trauma and Acute Care Service, St Michael’s Hospital
- Mohammed Siddiqui
- Unit of Digestive, Hepato-Pancreato-Biliary Surgery and Liver Transplantation, Henri Mondor University Hospital, AP-HP, and University of Paris Est, UPEC
- Iradj Sobhani
- Department of Gastroenterology and Digestive Endoscopy, Henri Mondor Hospital, AP-HP, and University of Paris Est, UPEC
- Richard P. ten Broek
- Department of Surgery, Radboud University Medical Center
- Luigi Zorcolo
- Department of Surgery, Colorectal Surgery Unit, University of Cagliari
- Maria Clotilde Carra
- University Paris Diderot, Rothschild Hospital, AP-HP
- Yoram Kluger
- Department of General Surgery, Rambam Healthcare Campus
- Fausto Catena
- Department of Emergency and Trauma Surgery of the University Hospital of Parma
- DOI
- https://doi.org/10.1186/s13017-018-0162-9
- Journal volume & issue
-
Vol. 13,
no. 1
pp. 1 – 20
Abstract
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
- Iatrogenic colonoscopy perforation
- Colonoscopy
- Gastrointestinal endoscopy
- Emergency surgery
- Laparoscopy
- Antibiotic therapy
