Pneumothorax, Pneumomediastinum, Pneumoperitoneum, Pneumoretroperitoneum, and Cervical Emphysema After Colonoscopy: A Case Report.

Colonoscopy is the gold standard for the diagnosis and screening of colorectal diseases. Although uncommon, perforation is the most serious complication and may result in significant morbidity and mortality. We report the case of a 48-year-old woman who developed bilateral pneumothorax, pneumomediastinum, pneumoperitoneum, pneumoretroperitoneum, and cervical emphysema during therapeutic colonoscopy. The patient underwent bilateral chest tube placement and exploratory laparotomy, which revealed emphysematous infiltration of the cecal serosa but no free perforation. She recovered uneventfully after antibiotic therapy and supportive care. This case highlights the importance of maintaining a high index of suspicion for atypical presentations of colonoscopy-related complications and emphasizes that prompt recognition and timely intervention can be lifesaving.