title: Left pneumothorax secondary to colonoscopic perforation of the sigmoid colon: a case report.
abstract: We present here the case of a 75-year-old woman who complained of acute abdominal pain after a diagnostic colonoscopy. Abdominal x-rays demonstrated pneumoperitoneum, whereas chest x-rays showed pneumomediastinum and left pneumothorax. A chest drain was placed and subsequently an exploratory laparoscopy was performed, during which air was found in the subserosa of the sigmoid colon and in the mesosigmoid secondary to perforation of a sigmoid diverticulum. The perforation was repaired and a protective loop colostomy was fashioned. The patient was discharged 8 days postoperatively in a good general condition. Although numerous cases of pneumoretroperitoneum and pneumomediastinum secondary to iatrogenic perforation of the colon have been described, reports of pneumothorax are much rarer. We, therefore, discuss the anatomic bases and the possible physiopathologic mechanisms responsible for this clinical complication.
authors.affiliation: Dipartimento di Scienze Chirurgiche, Facoltà di Medicina, University of Pavia, Italy. fedelovi@yahoo.com
authors.forename: Federico
authors.initials: F
authors.lastname: Lovisetto
authors.forename: Sandro
authors.initials: S
authors.lastname: Zonta
authors.forename: Emanuela
authors.initials: E
authors.lastname: Rota
authors.forename: Massimiliano
authors.initials: M
authors.lastname: Mazzilli
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Faillace
authors.forename: Alessandro
authors.initials: A
authors.lastname: Bianca
authors.forename: Alessio
authors.initials: A
authors.lastname: Fantini
authors.forename: Mauro
authors.initials: M
authors.lastname: Longoni
mesh_terms: D015746:Abdominal Pain / Q000209:etiology; D000368:Aged; D012809:Colon, Sigmoid / Q000293:injuries*; D003113:Colonoscopy / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007049:Iatrogenic Disease; D007431:Intraoperative Complications; D011027:Pneumoperitoneum / Q000000981:diagnostic imaging; D011030:Pneumothorax / Q000209:etiology*; D014057:Tomography, X-Ray Computed