Pneumoperitoneum, pneumomediastinum, pneumopericardium and subcutaneous emphysema following colonoscopy- a case report

Abstract

Colonoscopy is a relatively safe procedure used in the diagnosis and treatment of colonic lesions. Complications such as bleeding, post-polypectomy electrocoagulation syndrome and perforation can occur during the procedure. Although bowel perforation is rare, it is the most serious complication and can lead to death.

Following perforation, air can leak into the peritoneal cavity or extra-peritoneally or a combination of the two. Combined intra-peritoneal and extra-peritoneal leakage of air following colonic perforation is rare.

We present a case of combined intra-peritoneal and extra-peritoneal leakage of air due to colonic perforation complicating colonoscopy presenting as pneumoperitoneum, pneumomediastinum, pneumopericardium and subcutaneous emphysema in a 68 year old woman who was successfully managed non-operatively.