PMC3015914_01
Rectal perforation (3-cm long along the transverse axis just above the second valve of Houston).
jsls-13-1-69-g01.jpg
PMC3015914_01_jsls-13-1-69-g01.jpg
F1
It was located just above the second valve of Houston, along the transverse axis (Figure 1).
Clip placement (9 clips were used but 2 were misplaced).
jsls-13-1-69-g02.jpg
PMC3015914_01_jsls-13-1-69-g02.jpg
F2
It was promptly closed using a rotating clip-fixing device (Figure 2).
(A) Scout CT scan showing significant retroperitoneal air (around the right kidney, both flanks, and left retroperitoneum); (B) CT scan cross-section showing right anterior peri-vesical air and right prerectal air with right retroperitoneal air. Projecting endoscopic clips are also evident; (C) abdominal CT scan cross-section showing subhepatic intraperitoneal free air.
jsls-13-1-69-g03.jpg
PMC3015914_01_jsls-13-1-69-g03.jpg
F3
A chest, abdominal, and pelvic CT scan was obtained showing pneumoretroperitoneum, pneumomediastinum, and subcutaneous emphysema with modest intraabdominal subhepatic free air (Figure 3).