Korean Journal of Gastrointestinal Endoscopy 2011;42(1): 38-42.
대장내시경 천공에 의한 기흉, 종격동기종, 피하공기증, 공기후복막증
임주견ㆍ김영묵ㆍ박성남
왈레스기념 침례병원 내과
Pneumothorax, Pneumomediastinum, Subcutaneous Emphysema, Pneumoretroperitoneum Secondary to Colonoscopic Perforation
Ju Kyeon Yim, M.D., Yeong Muk Kim, M.D. and Sung Nam Park, M.D.
Department of Internal Medicine, Wallace Memorial Baptist Hospital, Busan, Korea
Abstract
A colonoscopic perforation is rare but can cause a fatal outcome. A perforation can be intraperitoneal or retroperitoneal. Air in the retroperitoneal space by perforation can spread to the mediastinum, pleura, and subcutaneous tissue through the visceral space. Therefore, a colonoscopic perforation may manifest as a pneumomediastinum, a pneumothorax, or subcutaneous emphysema without a peritoneal irritation sign. Although a colonoscopic perforation is treated mainly with an operation, medical treatment may be possible in selected cases, especially for a perforation to the retroperitoneal area or that under peritoneal reflexion. Clipping of a perforation is effective for medical treatment. We experienced a case of pneumothorax, pneumomediastinum, subcutaneous emphysema and pneumoretroperitoneum without peritoneal irritation following a diagnostic colonoscopy, which was diagnosed after 3 days because of atypical symptoms but was successfully managed with medical treatment and clipping. (Korean J Gastrointest Endosc 2011;42:38-42)
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