Behçet'lilerde ileokolonik perforasyon riski: Üç olgu sunumu ve literatürün gözden geçirilmesi

Kaynakça (3)

1. Behcet H. Über rezidivierende aphthose, durch ein virus verursachte geschwure am mund, am auge und an den genitalien. Dermatologische Wochenschrift 1937;105:1152-7.
2. Kobayashi K, Ueno F, Bito S, et al. Development of consensus statements for the diagnosis and management of intestinal Behcet's disease using a modified Delphi approach. J Gastroenterol 2007;42:737-45.
3. Sakane T, Takeno M, Suzuki N, Inaba G. Behcet's disease. N Engl J Med 1999;341:1284-91. Endoscopic procedures such as gastroscopy and colonoscopy are widely used for the diagnosis of gastrointestinal system diseases. Colonic perforation resulting from colonoscopic and sigmoidoscopic procedures is a rare but serious compli cation with high rates of morbidity and mortality (48-51). The frequency of perforations after colonoscopy is estimated to be 0.03% to 0.8% for diagnostic colonoscopy and 0.15% to 3% for therapeutic colonoscopy (22). Perforations that oc curs during diagnostic colonoscopy are due to direct mechan ical penetration with the instrument tip, sharp flexion of the colonoscope, high pressure applied when a loop is formed or barotrauma as a result of aggressive gas insufflations (23,24). In a retrospective study, the most common underlying cause for bowel perforation was direct mechanical injury of the co lonic wall by the colonoscope. It occurred in patients with diverticular disease or a strictured, severely diseased colonic segment. These risk factors were in accordance with those noted in the literature (52,53). The most frequent site of per foration was the sigmoid colon, similar to other studies (54 ). which may be explained by its anatomical characteristics of frequent redundancy, or narrowing from diverticular dis ease, or adhesions after previous pelvic operations (57). In this study, iatrogenic colon perforation did not occur in Crohn's disease or ulcerative colitis patients. There were no histories of abdominopelvic operation in BD patients and colonic diverticula were not seen during the colonoscopic examination in this group. We thought that barotrauma in duced perforation for all perforations occurred in the proxi- mal colon. In conclusion, colonoscopy is a scanning modality that is not only diagnostic but may also be used periodically during fol low- ups, or to display relapses responsive to medical treat ment. Perforation may develop during colonoscopy a proce dure, especially discrete ulcers that typically have a round or oval ''punched-out'' appearance with a tendency