[Retropneumoperitoneum due to endoscopic dilation. Is conservative management possible?]

Area of Science:

• Gastroenterology
• Colorectal Surgery
• Interventional Endoscopy

Background:

• Anastomotic stricture incidence and definition vary, often presenting as asymptomatic or partial intestinal obstruction.
• Colorectal anastomosis strictures are a known complication following lower anterior resection for rectal neoplasm.

Purpose of the Study:

• To report a case of anastomotic perforation following endoscopic dilation for colorectal stenosis.
• To discuss the management of this rare complication.

Main Methods:

• An 80-year-old patient underwent lower anterior resection and subsequent ileostomy closure.
• Endoscopic dilation was performed for symptomatic colorectal anastomosis stenosis.
• The patient developed anastomotic perforation, managed conservatively.

Main Results:

• Endoscopic dilation led to anastomotic perforation with pneumoperitoneum, retropneumoperitoneum, and pneumothorax.
• The patient was clinically and hemodynamically stable for conservative treatment.
• Conservative management resulted in satisfactory resolution of the perforation.

Conclusions:

• Endoscopic dilation for colorectal strictures carries a risk of colonic perforation.
• Management options for stricture-related perforation range from conservative measures to surgical intervention.
• Conservative management can be successful in selected cases of anastomotic perforation.