Massive gas leak post colonoscopic biopsy

Case contributed by Chris O'Donnell
Diagnosis certain

Presentation

Had colonoscopy in the morning with biopsy of obvious cecal mass. Now distension and pain in the evening ? perforation

Patient Data

Age: 75
Gender: Female

Extensive free gas adjacent to a mass lesion in the cecum/ascending colon (arrow) that was biopsied at colonoscopy. Free gas is also in the peritoneal cavity, subcutaneous fat of the abdomen and buttocks, retroperitoneum, mediastinum and chest wall.

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