Abstract

Argon Plasma Coagulation (APC), a new endoscopic hemostatic method of non-contact electrocoagulation, is widely used for ablation of Barrett's esophagus, residual tissue after polypectomy, palliation of malignancy and hemostasis of radiation proctopathy, bleeding peptic ulcers, prevention of esophageal varices. Although a safe and effective procedure, if used inappropriately, side effects such as failure of hemostasis, perforation, asymptomatic submucosal emphysema, and pneumoperitoneum can occur. Perforations progressing to peritonitis require surgery, but a pneumoperitoneum can recover with conservative treatment. Therefore, clinicians should distinguish these two different cases. There are no domestic cases of asymptomatic pneumoperitoneum caused by APC. In two cases treated by endoscopic submucosal dissection of polypectomy and early gastric cancer, asymptomatic pneumoperitoneum occurred after argon plasma coagulation treatment. We present these two cases of asymptomatic pneumoperitoneum treated successfully by conservative treatment without complications. (Korean J Gastrointest Endosc 2008;37:355-359)

• Keywords: Argon plasma coagulation, Pneumoperitoneum