Korean J Gastrointest Endosc.  2007 Aug;35(2):116-120.

A Case of Pneumoperitoneum, Pneumoretroperitoneum, Pneumomediastinum, and Subcutaneous Emphysema after Endoscopic Submucosal Resection

• Shin CJ
• You KW
• Pyo SB
• Moon HC
• Hong GY
• Oh DH
• Park SW
• Lim YK
• Seo KS

Abstract

Flexible fiberoptic colonoscopy is extensively used for the diagnosis and management of colorectal disease. Many possible complications can occur. The most common and most serious complications are hemorrhage, perforation and respiratory problems. Colonic perforation usually results in a fatal and emergent condition. However, management of iatrogenic colonic perforation has been controversial. The choice between the medical versus the surgical approach has been dependent on the mechanism of the perforation, bowel preparation, location, size of the defect and severity of symptoms. We report here a case where colonic perforation emerged during endoscopic submucosal resection of a rectal tumor. The rectal perforation was accompanied with pneumoperitoneum, subcutaneous emphysema, pneumoretroperitoneum and pneumomediastinum. As the bowel preparation was excellent, intravenous antibiotics and total parenteral nutirition were administered. The patient was treated successfully without any complications.

Keyword

Colonscopy; Rectal perforation; Pneumoretroperitoneum; Subcutaneous emphysema; Pneumomediastinum

MeSH Terms

Anti-Bacterial Agents
Colon
Colonoscopy
Diagnosis
Hemorrhage
Humans
Mediastinal Emphysema*
Pneumoperitoneum*
Rectal Neoplasms
Retropneumoperitoneum*
Subcutaneous Emphysema*
Anti-Bacterial Agents