Abstract:
Transanal excision (TAE) is considered a safe, alternative approach for patients with early stage
of rectal cancer. Complications associated with TAE are rare, such as bleeding, perforation,
incontinence, and rectal stricture. Subcutaneous emphysema is early complication of laparoscopic surgery, common during upper gastrointestinal and gynecological surgery. We report
a case of retroperitoneal and subcutaneous emphysema emerging after TAE of rectal tumor.
The patient presented with changed bowel habits. Colonoscopy with pathology reports, ultrasound, and magnetic resonance imaging showed an adenocarcinoma in the rectum at a 5
cm from the anus and did not reveal signs of invasive growth, pathologic lymph nodes, or
systemic metastases. After surgery patient complained about abdominal pain and severe subcutaneous emphysema. Computed tomography showed retroperitoneal emphysema with no
signs of rectal wall defect. He received antibiotics and was kept hospitalized with a solid diet
and the retroperitoneal air disappeared on the thoracic X-ray. Patients who remain clinically
stable or steadily improving without signs if peritonitis can be managed conservatively. Only
in case of ineffectiveness of conservative therapy, undergo surgery