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Perforations are sometimes witnessed during colonoscopy, and anecdotal series describe their successful closure with hemostatic clips, over-the-scope clips, and the new technique of endoscopic suturing.
In the current retrospective analysis of 21 witnessed perforations, 5 were closed with clips and 16 with suturing. Four of the clipped patients had pain after the procedure and underwent laparoscopy that indicated incomplete perforation closure. One clipped patient had severe pain after the procedure and underwent another colonoscopy during which the clips were removed and the site was successfully closed with suturing. Closure was successful in the other 16 patients with perforations closed by suturing.