A 38-year-old man known with inflammatory bowel disease, received an ileostomy and a blinded colon. Eight years later the patient underwent a painful colonoscopy, performed under suspicion of malignancy in the blinded colon. Two days later the patient was admitted due to hoarseness, throat pain and a feeling of neck swelling but no abdominal pain. A chest X-ray showed subcutaneous emphysema in the neck region and pneumoperitoneum. We conclude, that colonoscopies can give a variety of complications, such as perforation in the colon with secondary subcutaneous emphysema in the neck and throat region.