Iatrogenic perforation of the colon and rectum.
ABSTRACT In eight years at Cook County Hospital, 42,000 barium enemas, 16,325 proctosigmoidoscopies, and 1207 colonoscopies were performed. All endoscopic procedures were done by the house staff. There were three perforations due to proctosigmoidoscopy, with one death; three perforations due to colonoscopy, with no deaths; and seven perforations due to barium enema, with no survivors. The adjuvant effect of barium sulfate is proposed as the most likely cause for this excessively high mortality in barium-enema perforation.
Journal of Women s Imaging 01/2003; 5(1):25-39. DOI:10.1097/00130747-200302000-00005
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ABSTRACT: A barium enema is a diagnostic and therapeutic procedure commonly used for colon and rectum problems. Rectal perforation with extensive intra- and/or extraperitoneal spillage of barium is a devastating complication of a barium enema that leads to a significant increase in patient mortality. Due to the low number of reported cases in recent scientific literature and the lack of experience with the management of these cases, we would like to present our treatment approach to a rare case of retroperitoneal contamination with barium, followed by its intraperitoneal involvement during a diagnostic barium enema. Our experience with long-term management of the patient and the good outcome will be depicted in this paper.12/2014; 30(6):285-9. DOI:10.3393/ac.2014.30.6.285
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ABSTRACT: Background The last 30 years have witnessed a signifi-cant increase in the diagnosis of early-stage rectal cancer and the development of new strategies to reduce the treatment-related morbidity. Currently, there is no con-sensus on the definition of early rectal cancer (ERC), and the best management of ERC has not been yet defined. The European Association for Endoscopic Surgery in collabo-ration with the European Society of Coloproctology developed this consensus conference to provide recom-mendations on ERC diagnosis, staging and treatment based on the available evidence. Methods A multidisciplinary group of experts selected on their clinical and scientific expertise was invited to critically review the literature and to formulate evidence-based recommendations by the Delphi method. Recommendations were discussed at the plenary session of the 14th World Congress of Endoscopic Surgery, Paris, 26 June 2014, and then posted on the EAES website for open discussion. Results Tumour biopsy has a low accuracy. Digital rectal examination plays a key role in the pre-operative work-up. Magnification chromoendoscopy, endoscopic ultrasound and magnetic resonance imaging are complementary staging modalities. Endoscopic submucosal dissection and transanal endoscopic microsurgery are the two established approaches for local excision (LE) of selected ERC. The role of all organ-sparing approaches including neoadjuvant therapies followed by LE should be formally assessed by randomized controlled trials. Rectal resection and total mesorectal excision is indicated in the presence of unfa-vourable features at the pathological evaluation of the LESurgical Endoscopy 01/2015; 29(4). DOI:10.1007/s00464-015-4067-3 · 3.31 Impact Factor