2016 Volume 36 Issue 4 Pages 819-822
A 57-year-old male was admitted to the hospital for the treatment of pharyngeal and esophageal cancer. Preoperative examination revealed a rectal carcinoid. Therefore, after the operation for the pharyngeal and esophageal cancer, the patient underwent transanal excision (TAE) for the rectal carcinoid. The TAE was a full-thickness excision, and the defect was repaired. Although there were no signs of peritoneal irritation after the TAE, the WBC count and serum CRP were elevated. Abdominal computed tomography (CT) revealed retroperitoneal emphysema with gas in the retroperitoneum and mesenterium. The patient was treated conservatively with antibiotics and nil by mouth. However, as the vital signs became unstable, colostomy was performed on postoperative day 3. The patient recovered uneventfully after the colostomy. While postoperative complications of TAE are rare as compared to open surgery, caution should be exercised against the possible development of complications such as retroperitoneal emphysema after TAE.