Chest
Roentgenogram of the MonthA Subtle Chest Radiographic Finding: Where Is the Pathology?
Section snippets
Diagnosis: Subcutaneous emphysema secondary to a perforated diverticular abscess
The chest radiograph was remarkable for subcutaneous air along the left lateral chest wall (Fig 2), with no evidence of pneumothorax related to the attempted cental line placement. Necrotizing fasciitis along the surgical wound site and pneumomediastinum were absent. In retrospect, the patient had vague abdominal pain, heme-positive stools, and lower quadrant tenderness for at least two days prior to surgery. Postoperatively, worsening abdominal pain and altered mental status developed. The
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Cited by (5)
Subcutaneous emphysema of the thorax heralding colonic perforation
2001, Annals of Thoracic SurgeryCitation Excerpt :The additional hiatus between the subdiaphragmatic space and mediastinum created by surgical dissection to free the xiphoid process before median sternotomy can only assist this process. These anatomic studies are borne out by a number of case reports relating subcutaneous emphysema of the thorax to perforation of the subdiaphragmatic gastrointestinal tract including colonic perforation due to radiologic [2] and endoscopic procedures [3], colonic carcinoma and diverticulitis [4], and rectal barotrauma [5]. In our patient, gas from an initial retroperitoneal perforation passed through the retroperitoneum to present in the thoracic subcutaneous tissues and after subsequent intraperitoneal involvement produced the onset of peritonitis.
Subcutaneous emphysema as an uncommon presentation of child abuse
1997, American Journal of Emergency MedicinePneumomediastinum, Pneumopericardium, and Pneumoperitoneum Caused by Peridiverticulitis of the Colon: Report of a Case
2004, Diseases of the Colon and RectumSubcutaneous emphysema of the neck and colonic perforation
2002, Emergency Medicine Journal