Colonoscopy is a widely used procedure and although colonoscopy is generally safe, it could have both gastrointestinal and non-gastrointestinal complications. The aim of this report is to assess the major complications of colonoscopies performed by one expert gastroenterologist.

We analyzed the rates of polyp detection, adenoma detection and adverse events in all the colonoscopies performed by one expert gastroenterologist during 23 years (1994-2017). Demographic factors, including age, race, gender, colonoscopy findings and patient comorbidities were recorded.

During 23 years, nearly 9000 colonoscopies and about 1700 polypectomies were performed. The polyp detection rate (PDR) and adenoma detection rate (ADR) were about 18% and 14%, respectively. The number of serious complications was six (0.07%). Colonic perforation occurred in five patients (0.06%) that for three of them polypectomy was performed. One patient suffered from cardiac arrest just after colonoscopy in the recovery room and died 20 days after colonoscopy (0.01%).

Although the rate of adverse events after colonoscopy was low, it is still an important consideration in developing screening recommendations.