Procedure for prolapsed hemorrhoid (PPH) is well recognized alternative to the traditional hemorrhoidectomy, and is associated with reduced pain and earlier return to normal activity. Over the past decade, there have been reports of severe life-threatening complications after a PPH, although the incidence is very low. Rectal perforation due to staple-line dehiscence is one of the serious complications that can cause severe pelvic sepsis or a pneumoretroperitoneum. Here, the first Korean case of a pneumoretroperitoneum due to staple-line dehiscence is described.
Hemorrhoidectomy ; Hemorrhoids* ; Incidence ; Retropneumoperitoneum* ; Sepsis

Retroperitoneal duodenal rupture is rare and is often difficult to diagnose on the plain abdominal x-ray. From a review of the plain abdomen films of 21 cases with retroperitoneal duodenal rupture, confirmed by operation, pneumoretroperitoneum was revealed in 16 cases; Air in the peritoneum was manifested as a bubbly shadow in 12 cases, a renal halo in 9 cases, air shadow along the right psoas margin in 2 cases, air along the diaphragmatic crus in 2 cases and air in the right properitoneal fat in 2 cases, US and CT also revealed air bubbles and fluid collection around the right kidney. We recommend the plain abdomen as a useful diagnostic method for detection of pneumoretroperitoneum.
Abdomen* ; Kidney ; Methods ; Peritoneum ; Retropneumoperitoneum ; Rupture*

Endoscopic submucosal dissection (ESD) is widely accepted as an alternative treatment to surgical resection for gastric neoplastic lesions. Among the complications of gastric ESD, perforation is usually manifested as a pneumoperitoneum. Here, we report a patient with a right-sided pneumothorax, pneumoperitoneum, and pneumoretroperitoneum as complications of gastric ESD. The patient recovered without further complications using conservative treatment, including endoscopic clipping, nasogastric drainage, and insertion of a chest tube.
Chest Tubes ; Drainage ; Endoscopy ; Humans ; Pneumoperitoneum ; Pneumothorax* ; Retropneumoperitoneum

No abstract available.
Colon* ; Colonoscopy* ; Mediastinal Emphysema* ; Pneumoperitoneum* ; Retropneumoperitoneum* ; Subcutaneous Emphysema*

No abstract available.
Colon* ; Colonoscopy* ; Mediastinal Emphysema* ; Pneumoperitoneum* ; Retropneumoperitoneum* ; Subcutaneous Emphysema*

The use of colonoscopy is important to prevent colon cancer. Despite the safety of the colonoscopy procedure, the most common complication of a colonoscopy is perforation, which occurs with a rate of approximately 0.3% during diagnostic colonoscopy and occurs with a rate of approximately 1.1% with the use of therapeutic colonoscopy. Surgery is the treatment of choice for most cases of colonic perforation. With the development of endoscopic devices and techniques, conservative treatment of colonic perforation has been reported by the use of endoscopic clipping. We report here a patient with iatrogenic perforation of the sigmoid colon that was caused by diagnostic colonoscopy. The perforation presented as pneumoretroperitoneum, which was successfully treated with endoscopic clipping.
Colon ; Colon, Sigmoid ; Colonic Neoplasms ; Colonoscopy ; Humans ; Intestinal Perforation ; Retropneumoperitoneum

Transanal endoscopic microsurgery is considered a safe, appropriate, and minimally invasive approach, and complications after endoscopic microsurgery are rare. We report a case of sepsis and pneumoretroperitoneum after resection of a rectal lateral spreading tumor. The patient presented with rectal mucous discharge. Colonoscopy revealed a rectal lateral spreading tumor. The patient underwent an endoscopic transanal resection of the lesion. He presented with sepsis of the abdominal focus, and imaging tests revealed pneumoretroperitoneum. A new surgical intervention was performed with a loop colostomy. Despite the existence of other reports on pneumoretroperitoneum after transanal endoscopic microsurgery, what draws attention to this case is the association with sepsis.
Colonoscopy ; Colostomy ; Humans ; Microsurgery ; Retropneumoperitoneum* ; Sepsis* ; Transanal Endoscopic Microsurgery

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.
Colonoscopy ; Fatal Outcome ; Mediastinal Emphysema ; Mediastinum ; Pleura ; Pneumothorax ; Retroperitoneal Space ; Retropneumoperitoneum ; Subcutaneous Emphysema ; Subcutaneous Tissue

Colonoscopy is regarded as a relatively safe procedure and is widely performed. However, complications such as bleeding, perforation, and coagulation syndromes can occur during colonoscopy. Although bowel perforation is as rare as 0.4-1.9% of cases, it is the most serious and awful adverse event which can lead to a death. Colon perforation may occur as either intraperitoneal or extraperitoneal, or in combination. Right subdiaphragmatic free air suggests intraperitoneal perforation while pneumoretroperitoneum, pneumomediastinum, pneumopericardium, and subcutaneous emphysema suggest extraperitoneal perforation. Combined intraperitoneal and extraperitoneal perforation is very rare. Herein, we present a case of combined intraperitoneal and extraperitoneal colon perforation which manifested as pneumoretroperitoneum, pneumomediastinum, pneumopericardium, and subcutaneous emphysema. The lesion was closed with endoscopic clipping.
Colon ; Colonoscopy ; Hemorrhage ; Intestinal Perforation ; Mediastinal Emphysema* ; Pneumopericardium ; Retropneumoperitoneum* ; Subcutaneous Emphysema*

Colonoscopy is a commonly performed endoscopic procedure. Although it is generally considered to be safe, serious complications, such as colorectal perforation, can occur. Most colonic perforations are intraperitoneal and cause pneumoperitoneum with acute abdominal pain as the initial symptom. However, extraperitoneal perforations with pneumoretroperitoneum may happen, albeit rarely, with atypical initial symptoms. We report a rare case of rectosigmoid perforation occurring after diagnostic colonoscopy that developed into pneumoretroperitoneum, pneumomediastinum, pneumothorax, and subcutaneous emphysema, with a change in voice and neck swelling as the initial symptoms. The patient was successfully treated with endoscopic closure of the perforation and conservative management.
Abdominal Pain ; Colon ; Colonoscopy* ; Humans ; Mediastinal Emphysema* ; Neck ; Pneumoperitoneum ; Pneumothorax* ; Retropneumoperitoneum* ; Subcutaneous Emphysema* ; Voice