Pneumoperitoneum, retropneumoperitoneum and pneumomediastinum after stapled hemorrhoidopexy

Abstract

There are several surgical techniques for the treatment of hemorrhoidal disease, the most used currently being stapled hemorrhoidopexy. Complications of this procedure are rare, although they may occur. The aim of this study is to report the clinical case of a patient with severe complication of rectal perforation after stapled hemorrhoidopexy. A 44-year-old man who presented anal pain in his postoperative period of hemorrhoid with urgent computed tomography evidencing rectal perforation with pneumoperitoneum, retropneumo-peritoneum and pneumomediastinum. Rectal perforation is a specific complication of surgery using stapler. One of the serious consequences is pneumoperitoneum, whose air leaked through the rupture of the rectal wall can reach the mediastinum, causing pneumomediastinum. These complications can be avoided by taking care of the triggering of the stapler device, in addition to post-surgical evaluation, such as rectal exploration before discharge.