Penumomediastinum and Subcutaneous Emphysema Developed Following Gastric Endoscopic Submucosal Dissection: Two Cases

Jang, Hye Won; Kim, Beom Hee; Kang, Sun Hyung; Moon, Hee Seok; Seong, Jae Kyu; Jeong, Hyun Yong

doi:2013.13.2.119

Korean J Helicobacter Up Gastrointest Res > Volume 13(2); 2013 > Article

Case Report

The Korean Journal of Helicobacter and Upper Gastrointestinal Research 2013;13(2):119-123.
DOI: https://doi.org/10.7704/kjhugr.2013.13.2.119 Published online June 10, 2013.

Penumomediastinum and Subcutaneous Emphysema Developed Following Gastric Endoscopic Submucosal Dissection: Two Cases

Hye Won Jang, Beom Hee Kim, Sun Hyung Kang, Hee Seok Moon, Jae Kyu Seong, Hyun Yong Jeong

Department of Internal Medicine, Chungnam National University School of Medicine, Daejeon, Korea. Jeonghy@cnuh.co.kr

내시경적 위 점막하박리술 후 천공 없이 발생한 종격동기종과 피하공기증 2예

장혜원, 김범희, 강선형, 문희석, 성재규, 정현용

충남대학교 의학전문대학원 내과학교실

Abstract

Endoscopic submucosal dissection (ESD) is extensively used for the management of early gastric cancer. But many possible complications can occur. We report here two cases where subcutaneous empysema and pneumomediasinum occurred after ESD of early gastric cancers without perforation. The lesions were close to the esophagogastro-junction. The reason subcutaneous empysema and pneumomediasinum developed is lack of serosa of esophagus. Insufflated air may leak when the muscular layer is exposed during ESD. After intravenous antibiotics and total parenteral nutirition were administered, the patients improved without any other complications.

Key Words: Endoscopic submucosal dissection; Mediastinal emphysema; Subcutanous emphysema