She underwent lysis of adhesions, sigmoid colectomy, and a colostomy with Hartmann's pouch. It was thought that this was most likely the site of the previous polypectomy. She did well postoperatively and was discharged home on postop day 7. Diagnosis Colonic perforation after endoscopy Discussion Perforation is the most common major complication following diagnostic colonoscopy, whereas the most common complication after polypectomy is hemorrhage. These figures may be underestimates due to underreporting of complications.
Pneumatic perforation occurs when the intraluminal pressure is sufficient to rupture the colon wall.
This is more likely to occur if the colon wall is weakened by transmural inflammation, ulceration, or tumor. Experimental studies in human cadaver colons have shown that the cecum is the most susceptible to rupture, followed by the transverse colon, sigmoid colon, and rectum, in that order. This is explained by two factors. First, the wall of the right colon is thinner than that of the left colon. Second, the Law of LaPlace states that wall tension is directly related to the radius of a cylinder, in this case the colon lumen.