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In some clinics, colonoscopic retroflexion in the rectum is considered to be standard of care. However, little is known about the frequency of perforations during this procedure.
To learn more, investigators reviewed data from all 39,054 colonoscopies performed at three Denver hospitals between July 2001 and July 2008. Four cases of rectal perforation occurred during retroflexion, yielding an incidence rate of 0.10 per 1000 colonoscopies. Three of the perforations occurred during colonoscopies performed by experienced faculty endoscopists without fellow involvement; three were managed without surgical intervention; and in three cases, the endoscopist reported difficulty performing the retroflexion.