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Subcutaneous emphysema, pneumomediastinum, pneumoretroperitoneum, and pneumoscrotum: unusual complications of acute perforated diverticulitis.

Fosi S, Giuricin V, Girardi V, Di Caprera E, Costanzo E, Di Trapano R, Simonetti G - Case Rep Radiol (2014)

Bottom Line: The main symptoms of spontaneous subcutaneous emphysema are swelling and crepitus over the involved site; further clinical findings in case of subcutaneous cervical and mediastinal emphysema can be neck and chest pain and dyspnea.Radiological imaging plays an important role to achieve the correct diagnosis and extension of the disease.Radiological diagnosis was confirmed by the subsequent surgical exploration.

View Article: PubMed Central - PubMed

Affiliation: Department of Diagnostic Imaging, Molecular Imaging, Interventional Radiology and Radiation Therapy, University Hospital Tor Vergata, Viale Oxford 81, 00133 Rome, Italy.

ABSTRACT
Pneumomediastinum, and subcutaneous emphysema usually result from spontaneous alveolar wall rupture and, far less commonly, from disruption of the upper airways or gastrointestinal tract. Subcutaneous neck emphysema, pneumomediastinum, and retropneumoperitoneum caused by nontraumatic perforations of the colon have been infrequently reported. The main symptoms of spontaneous subcutaneous emphysema are swelling and crepitus over the involved site; further clinical findings in case of subcutaneous cervical and mediastinal emphysema can be neck and chest pain and dyspnea. Radiological imaging plays an important role to achieve the correct diagnosis and extension of the disease. We present a quite rare case of spontaneous subcutaneous cervical emphysema, pneumomediastinum, and pneumoretroperitoneum due to perforation of an occult sigmoid diverticulum. Abdomen ultrasound, chest X-rays, and computer tomography (CT) were performed to evaluate the free gas extension and to identify potential sources of extravasating gas. Radiological diagnosis was confirmed by the subsequent surgical exploration.

No MeSH data available.


Related in: MedlinePlus

The first abdomen CT scan revealed free gas in correspondence of anterior subdiaphragmatic region (a) and left parietocolic shower (b). Gas was visualized within the scrotal sac (pneumoscrotum) (c). Peritoneal fat stranding and inflammatory changes are observed (d) (black arrows).
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fig1: The first abdomen CT scan revealed free gas in correspondence of anterior subdiaphragmatic region (a) and left parietocolic shower (b). Gas was visualized within the scrotal sac (pneumoscrotum) (c). Peritoneal fat stranding and inflammatory changes are observed (d) (black arrows).

Mentions: A CT scan of the abdomen (Figure 1) showed intra-abdominal free gas in correspondence of anterior subdiaphragmatic region, left anterior and posterior crural region, and ipsilateral parietocolic shower. Free gas was also noted in the retroperitoneum in correspondence of the proximal portion of the sigmoid colon.


Subcutaneous emphysema, pneumomediastinum, pneumoretroperitoneum, and pneumoscrotum: unusual complications of acute perforated diverticulitis.

Fosi S, Giuricin V, Girardi V, Di Caprera E, Costanzo E, Di Trapano R, Simonetti G - Case Rep Radiol (2014)

The first abdomen CT scan revealed free gas in correspondence of anterior subdiaphragmatic region (a) and left parietocolic shower (b). Gas was visualized within the scrotal sac (pneumoscrotum) (c). Peritoneal fat stranding and inflammatory changes are observed (d) (black arrows).
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4127224&req=5

fig1: The first abdomen CT scan revealed free gas in correspondence of anterior subdiaphragmatic region (a) and left parietocolic shower (b). Gas was visualized within the scrotal sac (pneumoscrotum) (c). Peritoneal fat stranding and inflammatory changes are observed (d) (black arrows).
Mentions: A CT scan of the abdomen (Figure 1) showed intra-abdominal free gas in correspondence of anterior subdiaphragmatic region, left anterior and posterior crural region, and ipsilateral parietocolic shower. Free gas was also noted in the retroperitoneum in correspondence of the proximal portion of the sigmoid colon.

Bottom Line: The main symptoms of spontaneous subcutaneous emphysema are swelling and crepitus over the involved site; further clinical findings in case of subcutaneous cervical and mediastinal emphysema can be neck and chest pain and dyspnea.Radiological imaging plays an important role to achieve the correct diagnosis and extension of the disease.Radiological diagnosis was confirmed by the subsequent surgical exploration.

View Article: PubMed Central - PubMed

Affiliation: Department of Diagnostic Imaging, Molecular Imaging, Interventional Radiology and Radiation Therapy, University Hospital Tor Vergata, Viale Oxford 81, 00133 Rome, Italy.

ABSTRACT
Pneumomediastinum, and subcutaneous emphysema usually result from spontaneous alveolar wall rupture and, far less commonly, from disruption of the upper airways or gastrointestinal tract. Subcutaneous neck emphysema, pneumomediastinum, and retropneumoperitoneum caused by nontraumatic perforations of the colon have been infrequently reported. The main symptoms of spontaneous subcutaneous emphysema are swelling and crepitus over the involved site; further clinical findings in case of subcutaneous cervical and mediastinal emphysema can be neck and chest pain and dyspnea. Radiological imaging plays an important role to achieve the correct diagnosis and extension of the disease. We present a quite rare case of spontaneous subcutaneous cervical emphysema, pneumomediastinum, and pneumoretroperitoneum due to perforation of an occult sigmoid diverticulum. Abdomen ultrasound, chest X-rays, and computer tomography (CT) were performed to evaluate the free gas extension and to identify potential sources of extravasating gas. Radiological diagnosis was confirmed by the subsequent surgical exploration.

No MeSH data available.


Related in: MedlinePlus