ObjectiveTo investigate the related factors of intestinal perforation caused by colonoscopic inspection and treatment, and to analyze its diagnosis and treatment strategy. MethodsA total of 31 862 patients who underwent electronic colonoscopic inspection and treatment were enrolled, and the clinical data of those with intestinal perforation were retrospectively analyzed, including personal conditions, perforation factors, and diagnosis and treatment strategy. ResultsSixteen out of the 31 862 patients suffered from intestinal perforation due to colonoscopic operation, with the incidence rate of 0.05%, among which 9 cases suffered from perforation caused by colonoscopic inspection and 7 by colonoscopic treatment. All patients were cured and discharged after treatment, no cases died, with average hospital stay of 14.8 days. Perforation mainly occurred at the turning point of intestinal canal, including 2 cases in the rectum, 3 in the junction of rectum and sigmoid colon, 8 in the sigmoid colon, 2 in the splenic flexure, and 1 in the hepatic flexure. Treatment procedures included laparoscopic perforation repair(7 cases), open perforation repair(2 cases), perforation repair + terminal ileostomy(6 cases), and conservative treatment(1 case). Six patients were hospitalized again for ileostomy closure within 3 months to 6 months after operation. ConclusionsPerforation caused by colonoscopic inspection and treatment is likely to occur in the sigmoid colon. Careless operation, local intestinal wall weakness, and anatomical structure abnormality are the three important factors leading to intestinal perforation. Early detection and active surgery are the primary principles for perforation diagnosis and treatment, and laparoscopic repair of perforation is the preferred option.

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