title: [Retropneumoperitoneum due to endoscopic dilation. Is conservative management possible?].
abstract: BACKGROUND
  The incidence of anastomotic stricture varies due to the different definitions given to the condition. In most cases they are asymptomatic, and if there are symptoms, they are usually those of a partial intestinal obstruction.
  
  
  METHODS
  The case is presented of an 80 year old patient who underwent a lower anterior resection for rectal neoplasm. After ileostomy closure, he presented with subocclusive symptoms caused by stenosis of colorectal anastomosis. This stenosis was managed with endoscopic dilations, and one of these dilations produced an anastomotic perforation with pneumoperitoneum, retropneumoperitoneum, and pneumothorax. Once the patient was clinically and haemodynamically stable, the perforation was treated with conservative measures, resolving the complication satisfactorily.
  
  
  CONCLUSIONS
  The literature describes several management options for colorectal anastomoses strictures, such as surgical resection, rubber dilators, endoscopic dilation, all of which might produce colonic perforation. Its management ranges from conservative measures to surgical intervention.
authors.affiliation: Sección de Coloproctología, Servicio de Cirugía General, Hospital Clínico Universitario de Zaragoza, Zaragoza, España. Electronic address: esti.egallego@hotmail.com.
authors.forename: Estíbaliz
authors.initials: E
authors.lastname: Echazarreta-Gallego
authors.affiliation: Sección de Coloproctología, Servicio de Cirugía General, Hospital Clínico Universitario de Zaragoza, Zaragoza, España.
authors.forename: Elena
authors.initials: E
authors.lastname: Córdoba-Díaz de Laspra
authors.affiliation: Sección de Coloproctología, Servicio de Cirugía General, Hospital Clínico Universitario de Zaragoza, Zaragoza, España.
authors.forename: Manuela
authors.initials: M
authors.lastname: Elía-Guedea
mesh_terms: D000369:Aged, 80 and over; D000714:Anastomosis, Surgical / Q000009:adverse effects; D003108:Colonic Diseases / Q000150:complications* / Q000209:etiology; D000072700:Conservative Treatment; D003251:Constriction, Pathologic / Q000628:therapy; D004106:Dilatation / Q000009:adverse effects* / Q000379:methods; D004724:Endoscopy / Q000009:adverse effects* / Q000379:methods; D006801:Humans; D007081:Ileostomy; D007416:Intestinal Perforation / Q000150:complications* / Q000209:etiology; D008297:Male; D011027:Pneumoperitoneum / Q000601:surgery*; D011030:Pneumothorax / Q000601:surgery*; D011183:Postoperative Complications / Q000209:etiology / Q000601:surgery*; D012004:Rectal Neoplasms / Q000601:surgery; D012188:Retropneumoperitoneum / Q000601:surgery*
keywords: Anastomoses strictures; Colonoscopia; Colonoscopy; Estenosis anastomosis; Intestinal perforation; Perforación intestinal