Colonoscopy or Sigmoidoscopy Perforation Risk Factors

 

Risk factors:

(1) age >= 70 years

(2) number of comorbid conditions (the authors state increased risk is seen with >= 2 comorbid conditions, but the table below indicates that even 1 comorbid condition increases the risk)

(3) diverticulosis

(4) obstruction (for colonoscopy), abdominal pain (for sigmoidoscopy)

 

Comorbid Conditions	Rate per 1,000 Colonoscopies	Rate per 1,000 Sigmoidoscopies
0	1.7	0.8
1	5.1	2.0
>= 2	6.3	2.6

from Table 1, page 233

 

Limitations:

• Some patients with diverticulosis have large outpouchings which could rupture under any increase in pressure. Rupture of a diverticulum strikes me as different than one arising from pushing the scope through the bowel wall.

• Colonic carcinomas large enough to obstruct may be large enough to invade to the serosal surface.