Colonoscopy, which is one of the most
commonly performed gastrointestinal endoscopic procedures, has been used
for diagnostic and therapeutic purposes1. With the
recent rise in colonoscopy screening and the increasing prevalence of
colorectal cancer, the use of colonoscopy is steadily increasing
worldwide, which also leads to an increase in colonoscopy related
complications2,3. Colonoscopy is considered relatively
safe1,4,5, but it can cause complications such as
bleeding or perforation, especially in the elderly patients and patients
with inflammatory bowel disease2. Among
colonoscopy-related complications, colon perforation is the most serious
complication2. A recent systematic review of 55
studies reported the risk of perforation during screening colonoscopy as
0.4 per 10,000 case6. Kim et al. reported the
incidence of colon perforation as 0.5 to 8.5 per 10,000 case. Even
though colon perforation rarely occurs, it can lead to serious sequelae
such as death or sepsis caused by peritonitis1. From
the medico-legal perspective, colon perforation often tends to be
considered as a doctor’s negligence7. As a result,
doctors may take the defensive attitude of rejecting high-risk patients
or passively providing conservative treatment to avoid
litigation8-10.
Review of the medicolegal cases of medical accident can help us prevent
similar accidents in the future. From this perspective, written
judgments of medical lawsuits on colon perforation may provide useful
information to avoid similar accidents. Until now, a few reviews of the
cases on the complications of colonoscopy were mostly based on the
patient medical records or insurance company
records11-13, but no studies were based on the using
written medical lawsuit judgments.
The aim of this study is to identify the characteristics and causes of
medical accidents by analyzing lawsuits on colon perforation during
colonoscopy.