• Federico Lovisetto, Sandro Zonta, Emanuela Rota, Massimiliano Mazzilli, Giuseppe Faillace, Alessandro Bianca, Alessio Fantini, and Mauro Longoni.
• Dipartimento di Scienze Chirurgiche, Facoltà di Medicina, University of Pavia, Italy. fedelovi@yahoo.com
• Surg Laparosc Endosc Percutan Tech. 2007 Feb 1; 17 (1): 62-4.

AbstractWe present here the case of a 75-year-old woman who complained of acute abdominal pain after a diagnostic colonoscopy. Abdominal x-rays demonstrated pneumoperitoneum, whereas chest x-rays showed pneumomediastinum and left pneumothorax. A chest drain was placed and subsequently an exploratory laparoscopy was performed, during which air was found in the subserosa of the sigmoid colon and in the mesosigmoid secondary to perforation of a sigmoid diverticulum. The perforation was repaired and a protective loop colostomy was fashioned. The patient was discharged 8 days postoperatively in a good general condition. Although numerous cases of pneumoretroperitoneum and pneumomediastinum secondary to iatrogenic perforation of the colon have been described, reports of pneumothorax are much rarer. We, therefore, discuss the anatomic bases and the possible physiopathologic mechanisms responsible for this clinical complication.

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