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Laparoscopic repair of sigmoid colon perforation associated with colonoscopy – case report and review of the literature

Sigmoid colon perforation is rare and has been estimated to occur between 0.01 and 0.03% of the time. Treatment of colonic injury has progressed since the recognition of the value of colostomy or bowel exteriorization. The treatment guidelines take into consideration the time interval between perforation and treatment as well as the nature, the site, and the cause of perforation. We reported a 80 years old patient who sustained a colonic perforation during therapeutic colonoscopy. Laparoscopy was performed 5 hours after colonoscopy. Two 12-mm (infraumbilical and right medioclavicular line beneath umbilicus) and one 5-mm (left medioclavicular line in umbilical level) trocars were inserted in the abdomen under general anesthesia. When we induced Veress needle intraabdominal pressure was 4 mmHg due to gases from perforated bowel. Fecal matter was not identified in the peritoneal cavity. Local peritonitis was mild. The laceration on the front side of sigmoid colon (size 2x1 cm) was oversewn with three sutures using the endocorporeal knot technique. The omentum was then anchored over the lesion. The postoperative recovery was rapid and uneventful, fourth day after the surgery patient was discharge from hospital with normal bowel function. Laparoscopic surgery may become a useful tool for the safe, effective, and minimally invasive management of iatrogenic colonic perforation. Advantages of the minimally invasive approach include the ability to evaluate the entire colon for injuries, more rapid postoperative recovery, and improved cosmetic.

Sigmoid colon perforation; Laparoscopic surgery

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