Perforation. The patient may present directly from the endoscopy suite, but more often there is an interval lasting from several hours to days. Typically, the patient complains of abdominal pain and distension, and objective findings may include leukocytosis and fever.
Although perforations usually occur during the colonoscopic examination or within 24 h after the procedure[1-3], delayed perforation of the colon and rectum has been reported[38,39].
If you have a gastrointestinal or bowel perforation, you may experience: Abdominal pain or cramping, which is usually severe. Bloating or a swollen abdomen. Fever or chills.
Often, patients will not know they have a perforated bowel until symptoms are sever. Early signs of sepsis are: Body temperature above 101 F (38.3 C) or below 96.8 F (36 C) Chills.
Observe patients' breathing patterns and abdominal movements with breathing, and note any abdominal distention or discoloration. (In perforated peptic ulcer disease, patients lie immobile, occasionally with knees flexed, and the abdomen is described as boardlike.)
CT scan. Abdominal CT scans may help your doctor check where the gastrointestinal perforation is. Endoscopy or colonoscopy. Procedures like upper endoscopy may also help to locate the gastrointestinal perforation.
The tool that your doctor uses in a colonoscopy could push too hard against your colon. This can cause a small tear. Your doctor may need to repair it with surgery.
Rarely, complications of a colonoscopy may include: A reaction to the sedative used during the exam. Bleeding from the site where a tissue sample (biopsy) was taken or a polyp or other abnormal tissue was removed. A tear in the colon or rectum wall (perforation)
The most common site of perforation is the sigmoid colon (53–65%), followed by the cecum, the ascending colon, the transverse colon, the descending colon, and the rectum [6, 13, 15, 29, 50] (Fig. 1).
One of the most serious complications of colonoscopy is endoscopic perforation of the colon, which has been reported as between 0.03% and 0.7% [1, 2]. Although colonoscopic perforation (CP) occurs rarely, it can be associated with high mortality and morbidity rates.
Bleeding is one of the most common complications of colonoscopy, accounting for 0.3-6.1% of cases[35,36].
Although colonoscopy is considered a safe procedure, it is associated with complications including intestinal hemorrhage and perforation. Splenic trauma, such as laceration or even complete rupture is a rarely reported, but potentially fatal complication if undetected.
After the test, you may be bloated or have gas pains. You may need to pass gas. If a biopsy was done or a polyp was removed, you may have streaks of blood in your stool (feces) for a few days. Problems such as heavy rectal bleeding may not occur until several weeks after the test.
An intestinal perforation is a major life-threatening condition with high morbidity and mortality that requires emergency surgery. Despite improvements in surgical and medical treatments, the overall mortality rate is 30% and the mortality rate of cases that also have diffuse peritonitis is up to 70% [1,2,3,4].
The effects of the sedation could last up to a day, so you should not drive or operate any machinery until the following day. You may feel gassy or bloated for a while after the procedure because of the air that was injected into your intestine during the colonoscopy.
Up to one-third of patients experience abdominal pain, nausea, or bloating afterward, which may last hours to several days. Fortunately, severe complications including hemorrhage, perforation, and death are rare, with a total incidence of 0.28%.
One-third of the patients experienced MAEs, most prominently in the first 1–2 weeks after colonoscopy, and less common at 30 days post colonoscopy. The most frequently reported MAEs were abdominal pain, bloating and abdominal discomfort.
Barotrauma can result in colonic perforation and can be avoided by frequent monitoring of abdominal distention and minimal air or CO2 insufflation during the procedure.
Incidents of colonoscopic perforation are 0.029%% and 0.426% for diagnostic and therapeutic colonoscopy, respectively. The age ranged from 39 to 82 years (on average, 58 years).
In fact, most patients feel up to returning to normal activities within 24 hours. It's highly recommended that patients take it easy with scheduled activities for the first week after to allow enough time to get back to normal, especially if your doctor found and removed polyps during the procedure.
What Happens After the Colonoscopy? After the colonoscopy, you'll stay under observation for one or two hours to make sure you're okay. You'll feel groggy and sluggish. You won't be able to drive, so you'll need someone to take you home.