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It is important to realize that retroperitoneal emphysema may be seen as a complication of upper gastrointestinal endoscopy. Because of the increased frequency of endoscopic and associated procedures, it is important to realize that these striking roentgenographic findings may be associated with a benign clinical condition that will resolve with expectant management alone. Clinically, we might be forced to differentiate this complication with pathological perforation from the original lesion or with free perforation by the instrument depending on the clinical conditions.
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