PMC6079430_01
Colonoscopic finding. No definite perforation is seen. Hemostatic clipping and hot biopsy coagulation near the ileocecal valve were done.
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fig1
No obvious perforations were seen during the procedure (Figure 1), and no symptoms related to perforations, such as abdominal distension, abdominal and chest pain, or dyspnea were identified at the physical examination immediately after the procedure.
Electrocardiogram showing T wave inversion in the inferior and lateral leads.
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fig2
It showed a T wave inversion in the inferior and lateral leads, without any pacemaker activity (Figure 2).
(a) Abdominal X-ray showing subcutaneous emphysema, pneumomediastinum, pneumoretroperitoneum, and right subdiaphragmatic free air (black arrow). (b) Chest X-ray showing pneumomediastinum (red arrow). (c) Neck X-ray showing right cervical subcutaneous emphysema (green arrow).
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fig3
Abdominal CT scan showing pneumoperitoneum and pneumoretroperitoneum (a, b), mainly located at the epimesogastrium, at the right anterior and posterior pararenal and perihepatic spaces (c) (black arrows, red arrow).
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fig4
The abdominal and lower thorax contrast-enhanced computed tomography (CT) scan revealed pneumoperitoneum and pneumoretroperitoneum, mainly located at the epimesogastrium, at the right anterior and posterior pararenal and perihepatic spaces, as well as diverticulosis of the sigmoid colon (Figure 4).