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Perforation of the large bowel can occur as a complication of sigmoidoscopy, rectal or sigmoid biopsy, and even of a simple cleansing enema. If the perforation is extraperitoneal there may be no early symptoms and consequently there may be delay in diagnosis. The risk of perforation during these procedures is small but it should not be ignored. The performance of a barium enema shortly after a rectal or sigmoid biopsy may slightly increase the risk by converting a partial perforation into a complete one. Precautions can be taken to minimize the hazard.
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