Coagulation syndrome: Delayed perforation after colorectal endoscopic treatments

Figure 1 Chromoendoscopy showing a 30 mm laterally spreading tumor (non-granular type) located at the bottom of the cecum bottom.

Figure 2 Endoscopic submucosal dissection is performed safely without intraoperative perforation. The procedure time is 47 min.

Figure 3 The tumor is resected in an en bloc fashion, and the specimen measures 51 mm × 40 mm.

Figure 4 Abdominal contrast enhanced computed tomography 24 h after endoscopic submucosal dissection. Free air is not recognized.

Figure 5 Abdominal radiography 36 h after endoscopic submucosal dissection because of a complaint of severe abdominal pain. A large amount of free air is observed under the diaphragm.

Figure 6 Abdominal computed tomography 36 h after endoscopic submucosal dissection. A large amount of free air is observed on the surface of the liver and the intraperitoneal cavity.

Figure 7 A small perforation site is present in the surgical specimen.