The patient was a 71-year-old man who underwent low anterior resection for rectal cancer, wherein the reconstruction was performed by forming an anastomotic blind end of the sigmoid colon. There were perioperative complications, including acute renal failure and acute cardiac insufficiency, aspiration pneumonitis, and intra-abdominal abscess formation. At 15 months after the operation, the patient presented to us complaining of a sense of abdominal fullness and subcutaneous emphysema in the region of the closed drain hole in the left lower quadrant of the abdomen. Abdominal computed tomography showed intraperitoneal free air. An abdominal needle aspiration failed to have any favorable effect and gastrointestinal perforation was suspected. Then, lower gastrointestinal tract endoscopy revealed a perforation measuring 2 mm in diameter at the anastomotic blind end, that was closed with clips. Although we did not confirm perfect clip closure, the patient's symptoms improved and the intraperitoneal free air steadily decreased. The patient visits the hospital regularly for follow-up and is in good general condition.
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