Document Detail

A retrospective analysis of cecal barotrauma caused by colonoscope air flow and pressure.
MedLine Citation:
PMID:  15672054     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: This study addressed the question of whether barotrauma during colonoscopy is sufficient to rupture the colon. METHODS: A total of 3000 colonoscopies were retrospectively analyzed, and the colonoscopes used for these procedures were evaluated in an in vitro analysis. Air pressure at the tip of the colonoscopes and air flow through the instruments were measured. The equation F=F MAX-P TIP/R was used to graph flow values (F) from the maximum measured flow (F MAX), the calculated resistance to air flow offered by the colonoscope (R), and the air pressure observed at the colonoscope tip (P TIP ). RESULTS: Four perforations occurred during 1500 consecutive colonoscopies performed with equipment from one manufacturer (Pentax Precision Instrument Corp., Orangeburg, NY) whereas, no perforation occurred during 1500 consecutive colonoscopies performed with equipment from another manufacturer (Olympus America Corp., Melville, NY) ( p < or =0.06). The Pentax colonoscopes used in patients with barotrauma-induced cecal perforations insufflated air at a rate greater than 1.46 L/m at 80 mmHg intraluminal pressure. Olympus colonoscopes did not. In vitro maximum air-flow rates of 2 L/m at a tip pressure of 0 mm Hg separated the Pentax from the Olympus instruments ( p <0.022). Conclusions Colonoscopes with maximum flow rates of less than 2 L/m at 0 mmHg tip pressure have insufficient flow capacity to generate flows above 1.46 L/m at 80 mmHg intraluminal pressure and thus may protect patients from cecal barotrauma.
John A Woltjen
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Publication Detail:
Type:  In Vitro; Journal Article    
Journal Detail:
Title:  Gastrointestinal endoscopy     Volume:  61     ISSN:  0016-5107     ISO Abbreviation:  Gastrointest. Endosc.     Publication Date:  2005 Jan 
Date Detail:
Created Date:  2005-01-26     Completed Date:  2005-05-24     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0010505     Medline TA:  Gastrointest Endosc     Country:  United States    
Other Details:
Languages:  eng     Pagination:  37-45     Citation Subset:  IM    
Medical Center of Independence, Missouri, GI Laboratory, St. Mary's Hospital, Blue Springs, MO 64014, USA.
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MeSH Terms
Air Movements
Air Pressure
Barotrauma / etiology*
Cecum / injuries*
Colonoscopes / adverse effects*
Equipment Design
Middle Aged
Retrospective Studies
Rupture / etiology

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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