A 81-year-old woman with a 2-month history of low abdominal discomfort exacerbed by eating and defecation. The patient has a history as diabetes, like open cholecystectomy and appendectomy ovarian cystectomy. After colon preparation, colonoscopy was performed. During insertion and withdrawal, the colonoscopy revealed no pathologic findings. Upon retroflexion of the colonoscope at the sigmoid colon, however, the patient complained severe pain and an approximately 5-mm perforation was observed. CT scan showed pneumoeritoneum associated to abdominal pain.
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