Korean J Gastrointest Endosc > Volume 35(2); 2007 > Article
Korean Journal of Gastrointestinal Endoscopy 2007;35(2): 116-120.
내시경 점막하 절개박리술 후 기복증, 공기후복막증, 종격동기종, 피하공기증이 병발한 직장천공의 내시경 치료 1예
신창준·유경완·표성봉·문형철·홍건영·오동현·박상욱·임연근·서강석
광주기독병원 내과
A Case of Pneumoperitoneum, Pneumoretroperitoneum, Pneumomediastinum, and Subcutaneous Emphysema after Endoscopic Submucosal Resection
Chang Jun Shin, M.D., Kyoung Wan You, M.D., Seoung Bong Pyo, M.D., Hyeung Cheul Moon, M.D., Gun Young Hong, M.D., Dong Hyun Oh, M.D., Sang Wook Park, M.D., Yeun Keun Lim, M.D. and Kang Suk Seo, M.D.
Department of Internal Medicine, Gwangju Christian Hospital, Gwangju, Korea
Abstract
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.
Key Words: Colonscopy, Rectal perforation, Pneumoretroperitoneum, Subcutaneous emphysema, Pneumomediastinum
주요어: 대장내시경, 직장천공, 공기후복막증, 피하공기증, 종격동기종
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