Colonoscopic barotrauma treated by conservative management: role of high-flow oxygen inhalation.

Most patients with colonoscopy-induced colonic perforation require urgent surgical intervention. Certain patients may, however, recover with conservative management. If the colonic perforation has been induced by barotrauma, there may be an extravasation of air which may lead to collection and tracking of air along the tissue planes, involving the retroperitoneum, peritoneal cavity, mediastinum, pleura, pericardium, or even the scrotum. The conservative treatment of colonic perforation includes bowel rest and antibiotics. Absorption of air collected in different body cavities may take some time, and inhalation of high-concentration oxygen may enhance the rate of gaseous absorption. We describe here a patient with colonic perforation induced by barotrauma, who recovered fully on conservative management with inhalation of high-concentration oxygen. We recommend that this approach should be used more frequently in such a situation.