An endoscopic mucosal resection (EMR) is an effective and safe therapeutic technique for treating a patient with a laterally-spreading tumor (LST). Colonoscopic-procedure-related complications are noted to be about 2.8% worldwide, and a perforation is the most common. Most colon perforations cause pneumoperitoneum. However, a perforation within the retroperitoneal portion of the colon (rectum and some of sigmoid colon) may cause an extraperitoneal perforation, and the leaking free air may induce pneumoretroperitoneum, pneumomediastinum, and subcutaneous emphysema, depending on the amount of discharged air. Herein, we present the case of a patient with an extraperitoneal colon microperforation which manifested as pneumoretroperitoneum, pneumomediastinum, and subcutaneous emphysema after an EMR for a sigmoid LST, which was successfully treated with medical treatment and endoscopic clipping.

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• The Close Relationship between Large Bowel and Heart: When a Colonic Perforation Mimics an Acute Myocardial Infarction
  Maria Francesca Secchi, Carlo Torre, Giovanni Dui, Francesco Virdis, Mauro Podda
  Case Reports in Surgery.2018; 2018: 1.     CrossRef
• Pneumoretroperitoneum, Pneumomediastinum, Pneumothorax, and Subcutaneous Emphysema after Diagnostic Colonoscopy
  Hee Sung Lee, Hwan Hee Park, Ju Seok Kim, Sun Hyung Kang, Hee Seok Moon, Jae Kyu Sung, Byung Seok Lee, Hyun Yong Jeong
  The Korean Journal of Gastroenterology.2017; 70(3): 145.     CrossRef

Procedure for prolapsed hemorrhoid (PPH) is well recognized alternative to the traditional hemorrhoidectomy, and is associated with reduced pain and earlier return to normal activity. Over the past decade, there have been reports of severe life-threatening complications after a PPH, although the incidence is very low. Rectal perforation due to staple-line dehiscence is one of the serious complications that can cause severe pelvic sepsis or a pneumoretroperitoneum. Here, the first Korean case of a pneumoretroperitoneum due to staple-line dehiscence is described.

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• The Effort to Reduce Vasovagal Reaction and Abdominal Pain During Stapled Hemorrhoidopexy
  Hyeonseok Jeong
  Annals of Coloproctology.2020; 36(5): 291.     CrossRef
• Partial Stapled Hemorrhoidopexy Versus Circular Stapled Hemorrhoidopexy
  Jin Sub Kim
  Annals of Coloproctology.2017; 33(1): 7.     CrossRef
• Early Experience With a Partial Stapled Hemorrhoidopexy for Treating Patients With Grades III–IV Prolapsing Hemorrhoids
  Hyeonseok Jeong, Sunghwan Hwang, Kil O Ryu, Jiyong Lim, Hyun Tae Kim, Hye Mi Yu, Jihoon Yoon, Ju-Young Lee, Hyoung Rae Kim, Young Gil Choi
  Annals of Coloproctology.2017; 33(1): 28.     CrossRef