RETROPERITONEAL AND ABDOMINAL-WALL EMPHYSEMA AFTER TRANSANAL EXCISIONOF A RECTAL-CARCINOMA

The use of transanal excision to remove rectal carcinomas is a relativ ely new application of this surgical procedure, which may require full thickness excision. Retroperitoneal and abdominal wall emphysema are potential complications of surgical procedures that breach the wall of the colon and rectum. Computed tomographic scans provide the dearest diagnostic picture of developing emphysema, and prompt diagnosis throu gh accurate interpretation of the scans is essential to minimize morbi dity and mortality. When the diagnosis is made early and no active inf ection accompanies the emphysema, the preferred approach to initial tr eatment is nonsurgical. This article presents a case in which local tr ansanal excision was performed on a 70-year-old male to remove a super ficial adenocarcinoma from the lower rectal wall. He developed postope rative retroperitoneal and abdominal wall emphysema. Conservative trea tment is discussed.