Peer Review Report For: Case Series: Management and outcomes of two cases of colonic perforation following colonoscopy [version 1; peer review: 2 approved with reservations]

Background Colonoscopy is a commonly utilized procedure in gastroenterology, but it carries risks of complications, with perforation being the most dreaded. The management of colonic perforation remains a topic of debate, as it can be effectively treated through surgical or non-surgical approaches. Our objective is to detail clinical presentations, diagnostic methods, and potential therapeutic options. Cases For this study, we gathered clinical and radiological data from two cases of colonic perforation following colonoscopy. We examined clinical presentations, diagnostic methods employed, and the different therapeutic approaches used for each case. In both cases, patients exhibited symptoms of colonic perforation following colonoscopy. The first case was managed conservatively, with progressive clinical improvement. The second case showed signs of pneumoperitoneum, but no perforation was found during laparoscopic intervention. Both patients recovered well and experienced no complications during follow-up. Conclusions Our study highlights the importance of understanding the risks associated with colonoscopy, particularly in patients with risk factors. It also underscores the diversity of available treatment approaches for iatrogenic colonic perforation, emphasizing the significance of a multidisciplinary approach in determining the optimal therapeutic strategy.