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Pneumoretroperitoneum, Pneumomediastinum, Pneumothorax, and Subcutaneous Emphysema after Diagnostic Colonoscopy. 2017

Hee Sung Lee, and Hwan Hee Park, and Ju Seok Kim, and Sun Hyung Kang, and Hee Seok Moon, and Jae Kyu Sung, and Byung Seok Lee, and Hyun Yong Jeong
Department of Internal Medicine, Chungnam National University School of Medicine, Daejeon, Korea.

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.

UI MeSH Term Description Entries
D007416 Intestinal Perforation Opening or penetration through the wall of the INTESTINES. Intestinal Perforations,Perforation, Intestinal,Perforations, Intestinal
D008478 Mediastinal Emphysema Presence of air in the mediastinal tissues due to leakage of air from the tracheobronchial tree, usually as a result of trauma. Emphysema, Mediastinal,Interstitial Emphysema,Interstitial Emphysema of Lung,Pneumomediastinum,Pulmonary Interstitial Emphysema,Emphysema, Interstitial,Emphysema, Pulmonary Interstitial,Emphysemas, Pulmonary Interstitial,Interstitial Emphysema, Pulmonary,Interstitial Emphysemas, Pulmonary,Lung Interstitial Emphysema,Mediastinal Emphysemas,Pneumomediastinums,Pulmonary Interstitial Emphysemas
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D009333 Neck The part of a human or animal body connecting the HEAD to the rest of the body. Necks
D011030 Pneumothorax An accumulation of air or gas in the PLEURAL CAVITY, which may occur spontaneously or as a result of trauma or a pathological process. The gas may also be introduced deliberately during PNEUMOTHORAX, ARTIFICIAL. Pneumothorax, Primary Spontaneous,Pressure Pneumothorax,Primary Spontaneous Pneumothorax,Spontaneous Pneumothorax,Tension Pneumothorax,Pneumothorax, Pressure,Pneumothorax, Spontaneous,Pneumothorax, Tension,Spontaneous Pneumothorax, Primary
D003113 Colonoscopy Endoscopic examination, therapy or surgery of the luminal surface of the colon. Colonoscopic Surgical Procedures,Surgical Procedures, Colonoscopic,Colonoscopic Surgery,Surgery, Colonoscopic,Colonoscopic Surgeries,Colonoscopic Surgical Procedure,Colonoscopies,Procedure, Colonoscopic Surgical,Procedures, Colonoscopic Surgical,Surgeries, Colonoscopic,Surgical Procedure, Colonoscopic
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000005 Abdomen That portion of the body that lies between the THORAX and the PELVIS. Abdomens
D012188 Retropneumoperitoneum Pathological or accidental introduction of air into the retroperitoneal space. Pneumoretroperitoneum

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