Collagenous Colitis and Colonic Perforation During Colonoscopy

Collagenous colitis can be associated with “fractures” of the proximal colon mucosa seen during colonoscopy. These linear cracks in the mucosa might be indicative of a brittle mucosa and submucosa that split during air insufflation. Prior to the current study, only eight cases of collagenous colitis-related perforation following colonoscopy have been documented, and these were published as individual case reports or small series.

In the current report, investigators described colonic perforations in 12 patients (11 women; age range, 44–80) with histologically defined severe collagenous colitis. Eight perforations occurred after colonoscopy, two occurred during colonoscopy, and two occurred during barium enema. Although a gross perforation wa…