Annals of Coloproctology  2016;32(6):234-238

doi:10.3393/ac.2016.32.6.234

Pneumoretroperitoneum, Pneumomediastinum, Subcutaneous Emphysema After a Rectal Endoscopic Mucosal Resection.

Hee Cheul JUNG 1 ; Hyun Jin KIM ; Sung Bok JI ; Jun Hyeong CHO ; Ji Hye KWAK ; Chang Min LEE ; Wan Soo KIM ; Jin Ju KIM ; Jae Min LEE ; Sang Su LEE

Affiliations

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Keywords

Colonoscopy; Perforation; Pneumoretroperitoneum; Pneumomediastinum; Subcutaneous emphysema

Country

Republic of Korea

Language

English

Abstract

An endoscopic mucosal resection (EMR) is an effective and safe therapeutic technique for treating a patient with a laterally-spreading tumor (LST). Colonoscopic-procedure-related complications are noted to be about 2.8% worldwide, and a perforation is the most common. Most colon perforations cause pneumoperitoneum. However, a perforation within the retroperitoneal portion of the colon (rectum and some of sigmoid colon) may cause an extraperitoneal perforation, and the leaking free air may induce pneumoretroperitoneum, pneumomediastinum, and subcutaneous emphysema, depending on the amount of discharged air. Herein, we present the case of a patient with an extraperitoneal colon microperforation which manifested as pneumoretroperitoneum, pneumomediastinum, and subcutaneous emphysema after an EMR for a sigmoid LST, which was successfully treated with medical treatment and endoscopic clipping.