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Colonic perforation after endoscopic biopsy of a submucosal tumor: successful conservative treatment

Colonoscopy is a powerful diagnostic and therapeutic procedure with a recognized risk of complications ranging from perforation to hemorrhage and septicemia. Perhaps the most dangerous complication associated with this procedure is bowel perforation. Although some colonic perforations can be treated medically, prompt surgery is generally preferred to minimize morbidity and mortality. We present a case of colonic perforation resulting from bite biopsy followed by mucosal resection of a submucosal tumor. Perforation occurred in a delayed manner despite prophylactic closure of the mucosal defect by the replacement of endoclips. The patient recovered spontaneously after antibiotic treatment and reduction of oral intake. We carried out successful conservative medical treatment of a minor iatrogenically induced bowel perforation without operation.