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March 1965

Mediastinal Emphysema After Rectal Biopsy

Author Affiliations

From the Department of Internal Medicine, Rancocas Valley Hospital. Consultant and Attending Physician, Department of Internal Medicine (Dr. Kohn).

Arch Surg. 1965;90(3):388-391. doi:10.1001/archsurg.1965.01320090066015

IN THE day-to-day practice of medicine, routine or frequently utilized procedures are often regarded as being devoid of danger to the patient. The following case history illustrates the occurrence of an unusual and potentially serious complication after the performance of a presumably innocuous procedure.

Report of a Case  A 34-year-old Caucasian man was admitted to the Rancocas Valley Hospital in Willingboro, NJ because of a three-week history of rectal bleeding during bowel movements. He was otherwise asymptomatic.The past medical history was unremarkable. Physical examination, including a digital rectal examination was normal. The hemoglobin, hematocrit, urinalysis, and fasting blood sugar values were normal.On the second hospital day, an upper gastrointestinal x-ray series was performed. A deformed duodenal bulb, attributed to scarring from previous ulceration was noted. No other abnormalities were seen. On the same day, a sigmoidoscopic examination was performed after a cleansing enema. A hypertrophied anal papilla was

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