Pneumothorax, Pneumomediastinum, Subcutaneous Emphysema, Pneumoretroperitoneum Secondary to Colonoscopic Perforation.
- Author:
Ju Kyeon YIM
1
;
Yeong Muk KIM
;
Sung Nam PARK
Author Information
1. Department of Internal Medicine, Wallace Memorial Baptist Hospital, Busan, Korea. lovetoje@hanmail.net
- Publication Type:Case Report
- Keywords:
Colonoscopy;
Perforation;
Pneumothorax;
Pneumomediastinum;
Subcutaneous emphysema
- MeSH:
Colonoscopy;
Fatal Outcome;
Mediastinal Emphysema;
Mediastinum;
Pleura;
Pneumothorax;
Retroperitoneal Space;
Retropneumoperitoneum;
Subcutaneous Emphysema;
Subcutaneous Tissue
- From:Korean Journal of Gastrointestinal Endoscopy
2011;42(1):38-42
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
A colonoscopic perforation is rare but can cause a fatal outcome. A perforation can be intraperitoneal or retroperitoneal. Air in the retroperitoneal space by perforation can spread to the mediastinum, pleura, and subcutaneous tissue through the visceral space. Therefore, a colonoscopic perforation may manifest as a pneumomediastinum, a pneumothorax, or subcutaneous emphysema without a peritoneal irritation sign. Although a colonoscopic perforation is treated mainly with an operation, medical treatment may be possible in selected cases, especially for a perforation to the retroperitoneal area or that under peritoneal reflexion. Clipping of a perforation is effective for medical treatment. We experienced a case of pneumothorax, pneumomediastinum, subcutaneous emphysema and pneumoretroperitoneum without peritoneal irritation following a diagnostic colonoscopy, which was diagnosed after 3 days because of atypical symptoms but was successfully managed with medical treatment and clipping.