Major complications of coloscopy: Bleeding and perforation

The overall frequency and types of complications associated with diagnostic coloscopy and coloscopic polypectomy are unknown. A statewide survey of coloscopists was conducted to determine the morbidity and mortality associated with coloscopy. Twenty-eight physicians performed a total of 1,106 coloscopic procedures. 9 colonic perforations and 5 episodes of colonic bleeding resulted in a 1.3% complication rate. Explanations for several of the complications are identified and preventive measures proposed. 1 patient died of an unrecognized perforation of the sigmoid colon, resulting in a 0.09% mortality rate. Of 14 complications reported in this series, 12 occurred during the early experience (less that 40 procedures) of the coloscopist. Training programs in coloscopy need to be established in order to reduce the morbidity and mortality associated with a physician's early coloscopic experience.