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Although the management of a colonic perforation after a colonoscopy is still controversial, conservative therapy is commonly used in those whose colonoscopy reveals a small perforation, those whose condition is relatively good, those who were diagnosed belatedly, or those who have not developed the symptoms of generalized peritonitis. We encountered a case of recurrent colonic perforation after successful conservative treatment for a colonoscopic perforation of the sigmoid colon in a 69-year-old female, who was treated with tube sigmoidostomy. (J Korean Surg Soc 2007; 72:153-156)