Fig. 1Endoscopically proven perforation. (A) Diagnostic colonoscopy-associated perforation. The perforation occurred during excessive pushing of the colonoscope. It is relatively large. (B) Therapeutic colonoscopy-associated perforation. The perforation developed during endoscopic submucosal dissection (ESD) of colonic adenoma. It is relatively small and the surrounding area shows ESD ulcer.
Fig. 2Radiologically proven perforation. (A) An endoscopic submucosal dissection (ESD) ulcer shows no definite evidence of endoscopically proven perforation. (B) Follow-up X-ray taken right after the completion of ESD shows a large amount of pneumoperitoneum, which means the presence of microperforation at the ESD ulcer bed.
Fig. 3Endoscopic clipping. (A) A mural defect developed after endoscopic mucosal resection of colon polyp. (B) Five clips were applied and the perforation was closed completely.
Table 1Performance of Endoscopic Clipping in the Management of Diagnostic Colonoscopy-Associated Perforation
Table 2Performance of Endoscopic Clipping in the Management of Therapeutic Colonoscopy-Associated Perforation