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KMID : 0359020070350020116
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Korean Journal of Gastrointestinal Endoscopy
2007 Volume.35 No. 2 p.116 ~ p.120
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A Case of Pneumoperitoneum, Pneumoretroperitoneum, Pneumomediastinum, and Subcutaneous Emphysema after Endoscopic Submucosal Resection
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Shin Chang-Jun
You Kyoung-Wan
Pyo Sung-Bong
Moon Hyeong-Cheol
Hong Gun-Young
Oh Dong-Hyun
Park Sang-Wook
Yim Youn-Gun
Seo Kang-Seok
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Abstract
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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.
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KEYWORD
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Colonscopy, Rectal perforation, Pneumoretroperitoneum, Subcutaneous emphysema, Pneumomediastinum
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