Pneumorrhachis, subcutaneous emphysema, pneumomediastinum, pneumopericardium, and pneumoretroperitoneum after proctocolectomy for ulcerative colitis: report of a case.
This article presents the first known case of pneumorrhachis (spinal air), pneumomediastinum, pneumopericardium, pneumoretroperitoneum, and subcutaneous emphysema after proctocolectomy for ulcerative colitis. We review the patient's medical history, clinical and laboratory findings, radiographic data, and operative records, as well as the relevant literature. We describe the case of a young male with ulcerative colitis who developed pneumorrhachis, subcutaneous emphysema, pneumoretroperitoneum, pneumomediastinum, and pneumopericardium after a proctocolectomy with ileal pouch-anal anastomosis. Unlike the case we report, previously described episodes of pneumomediastinum and subcutaneous emphysema in patients with ulcerative colitis developed before operative intervention. We offer possible explanations for these unusual complications based on analysis of this case and thorough review of the literature.
Holton
Luther H
LH
Department of Surgery, Temple University Hospital, Philadelphia, Pennsylvania 19140, USA.
Migaly
John
J
Rolandelli
Rolando H
RH
D000328:Adult; D003093:Colitis, Ulcerative / Q000601:surgery*; D006801:Humans; D008297:Male; D008478:Mediastinal Emphysema / Q000000981:diagnostic imaging / Q000209:etiology*; D011026:Pneumopericardium / Q000000981:diagnostic imaging / Q000209:etiology*; D011030:Pneumothorax / Q000000981:diagnostic imaging / Q000209:etiology*; D011183:Postoperative Complications; D016737:Proctocolectomy, Restorative / Q000009:adverse effects*; D011859:Radiography; D012188:Retropneumoperitoneum / Q000000981:diagnostic imaging / Q000209:etiology*; D013122:Spinal Diseases / Q000000981:diagnostic imaging / Q000209:etiology*; D013352:Subcutaneous Emphysema / Q000000981:diagnostic imaging / Q000209:etiology*