Abstract
A 66-year-old male was admitted to the hospital for diagnosis and treatment of a rectal lesion which was pointed out by health care system. All a about 20mm in diameter located about 5cm from the analring was observed by colonoscopy. The lesion was well differentiated adenocarcinoma. On December 2, 1995 we tried an endoscopic mucosal resection (EMR) for it. Mucosal defect department was about 4cm in diameter. Proper Muscular was observed clearly that department, however, it was stopped bleeding sufficiently. Although there was no peritoneal sign on the next mornig. WBC was 24, 600/mm3 and CRP was 10.5mg/dl on a blood biochemistry inspection. There was a gas image around both iliopsoas muscle in an abdominal X-ray examination, and a diagnosis of retroperitoneal emphysema was made. The internal rectal pressure is increasing by air feeding, when lower rectal lesions are resected by using an endoscope. There is possibility that retroperitoneal emphysema may be induced after EMR depending on the size resected mucosa. Therefore, the mucosal defect department should be repaired by a transanal approach.
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