An 80-year-old male reported to the emergency room due to abdominal pain and bloating following apparently uneventful colonoscopy 12h before. Anteroposterior X-rays of the abdomen and thorax were obtained (Figs. 1 and 2). Evidence of massive pneumoperitoneum was seen in the form of a double wall sign (curved arrow), centralization of the liver and of all the abdominal organs (thick arrows), the presence of free fluid (thin arrow), and elevation of the diaphragm (arrow tips). Emergency surgery was performed, revealing pneumoperitoneum with massive purulent peritonitis due to sigmoid colon perforation (approximately 4cm). A Hartmann procedure was carried out, with sigmoid resection and a left flank colostomy. The patient was admitted to intensive care after the operation and was subsequently discharged without complications.
Please cite this article as: Serrano-Dueñas M, Rodriguez-Muñoz MJ, Portilla-Botelho M. Neumoperitoneo a tensión diferido tras colonoscopia. Med Intensiva. 2018;42:e18.
