Penumomediastinum and Subcutaneous Emphysema Developed Following Gastric Endoscopic Submucosal Dissection: Two Cases

Endoscopic submucosal dissection (ESD) is extensively used for the management of early gastric cancer. But many possible complications can occur. We report here two cases where subcutaneous empysema and pneumomediasinum occurred after ESD of early gastric cancers without perforation. The lesions were close to the esophagogastro-junction. The reason subcutaneous empysema and pneumomediasinum developed is lack of serosa of esophagus. Insufflated air may leak when the muscular layer is exposed during ESD. After intravenous antibiotics and total parenteral nutirition were administered, the patients improved without any other complications.