Microperforation after colonic endoscopic submucosal dissection, air in 5 separate locations

Endoscopic submucosal dissection (ESD) and endoscopic mucosal dissection (EMD) are recognized treatment procedures for mucosal lesions. There will always be a risk for complications even if they are performed by experienced specialists. In this study, we aimed to present a 58-year-old male patient in whom lesion was detected in the proximal part of the descending colon during a colonoscopy. Histopathological examination of the lesion revealed intramucosal carcinoma. The lesion was removed by ESD but after the intervention, bilateral pneumothoraxes, pneumoperitoneum, pneumoretroperitoneum, pneumomediastinum and pneumoderma complications observed. It is quite unlikely to encounter all of these complications together in one patient. In this paper, we would like to highlight the potential for complications after ESD, even for the rare and unexpected ones, to contribute to their recognition and treatment.