A Case of Perforation of the Transverse Colon Presented with Pneumomediastinum and Subcutaneous Emphysema after Surgical Resection of Gastric Cancer with Bursectomy

Abstract

A 79-year-old male patient complaining of dysphagia was diagnosed with gastric cancer (cT3 (SS) N1M0, cStage IIB) and underwent distal gastrectomy with bursectomy. On postoperative day (POD) 6, he suddenly developed septic shock, with acute renal and respiratory failure. CT imaging revealed pneumomediastinum and subcutaneous emphysema, and no focus of the infection was identified. He was kept under intensive care to stabilize his general condition. After resuming to eat a meal, he developed an abdominal abscess on POD 14. Drainage tubography revealed perforation of the transverse colon. He underwent loop ileostomy, and the perforation was closed. The results observed in the present case suggest that it is important to consider the possibility of perforation of the transverse colon in case of pneumomediastinum.