Rare Bilateral Massive Pneumothorax, Pneumomediastinum, Pneumoperitoneum, and Diffuse Subcutaneous Emphysema During Colonoscopy: Multidisciplinary Collaboration: Case Report.

While colonoscopy is generally considered to be a safe procedure, serious complications such as intestinal perforation may also occur. Herein, we describe an extremely rare clinical case of acute colonic perforation during colonoscopy treatment. A 55-year-old female patient with good health presented to our hospital with abdominal pain for 2 months. While undergoing endoscopic submucosal dissection (ESD) of a colonic polyp, the patient developed sudden abdominal distension and dyspnea. An emergency computed tomography (CT) scan was performed and demonstrated bilateral massive pneumothorax, pneumomediastinum, pneumoperitoneum, and generalized subcutaneous emphysema (SCE). The patient underwent gas extraction, bilateral intercostal pneumothorax drainage, and conservative medical management. The patient had a favorable postoperative course and was discharged home on day 14. This case report highlights the clinical rarity of gas extravasation complications during colonoscopy and underscores the importance of multidisciplinary collaboration for accurate diagnosis and effective management, thereby avoiding surgical procedures.