case_images: PMC6079430_01
case_images: Colonoscopic finding. No definite perforation is seen. Hemostatic clipping and hot biopsy coagulation near the ileocecal valve were done.
case_images: CRIS2018-8020197.001.jpg
case_images: PMC6079430_01_CRIS2018-8020197.001.jpg
case_images: fig1
case_images: 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.
case_images: Electrocardiogram showing T wave inversion in the inferior and lateral leads.
case_images: CRIS2018-8020197.002.jpg
case_images: PMC6079430_01_CRIS2018-8020197.002.jpg
case_images: fig2
case_images: It showed a T wave inversion in the inferior and lateral leads, without any pacemaker activity (Figure 2).
case_images: (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).
case_images: CRIS2018-8020197.003.jpg
case_images: PMC6079430_01_CRIS2018-8020197.003.jpg
case_images: fig3
case_images: 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).
case_images: CRIS2018-8020197.004.jpg
case_images: PMC6079430_01_CRIS2018-8020197.004.jpg
case_images: fig4
case_images: 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).