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Our study focused on the indications for conservative care.We conducted a retrospective review of 22 patients who were managed for colonoscopyinduced perforation from June 2004 to July 2009The initial reasons for having undergone colonoscopy included 12 cases for diagnosis (54.4%), and 10 cases for treatment (45.5%). The most common site of perforation was sigmoid colon (77.3%). Five patients (22.7%, Group I) underwent conservative treatment and 17 patients (77.3%) received operativeprocedures and invasive treatment who included 13 cases ofprimary closure, two cases of resection with stoma, one case of resection, and one case of drainage. Six cases (37.5%) were approached laparoscopically with simple closure. The duration of hospital stay was no different between the two groups (P = 0.432). Between the two groups, there was a significant difference between thepresence of abdominal pain and body temperature (P = 0.043, 0.011). All patients who were managed by conservative treatment have been diagnosed within 24 hours and received bowelpreparation even if there were no significant differences between two groupsConservative care for colonic perforation after colonoscopy is feasible for patients who have been diagnosed within 24 hours, without abdominal pain, with normal body temperature and received bowelpreparation.