Subcutaneous emphysema: a rare manifestation of a perforated diverticulitis in a patent inguinal canal.
Patients with complicated diverticulitis rarely present with extraperitoneal manifestations but the manifestation of subcutaneous emphysema appears even more seldom. We present the case of a patient with a history of diabetes and immunosuppression, who was admitted with sepsis in association with cellulitis and subcutaneous emphysema of the left groin. The absence of peritonism due to corticosteroid treatment, a history of a recent fall with an ilio- and ischio-pubic fracture and subcutaneous emphysema led to a delay in the diagnosis. The final diagnosis was a perforated diverticulitis in a patent inguinal canal, which was only revealed after surgery. The various complications of diverticulitis, including extraperitoneal manifestations, and associated microorganisms implicated in cellulitis and subcutaneous emphysema are briefly reviewed.
de Vries
Lambert
L
Internal Medicine Department, University Hospital Geneva, Rue Micheli-Du-Crest 24, 1211, Geneva 14, Switzerland.
Knoepfli
Anne-Sophie
AS
Konstantinidis
Philippe
P
Charbonney
Emmanuel
E
D000369:Aged, 80 and over; D003082:Colectomy / Q000379:methods; D012809:Colon, Sigmoid; D003937:Diagnosis, Differential; D004239:Diverticulitis, Colonic / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D017809:Fatal Outcome; D005260:Female; D006552:Hernia, Inguinal / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D006801:Humans; D007264:Inguinal Canal; D007813:Laparotomy; D010173:Palpation; D012422:Rupture, Spontaneous; D013352:Subcutaneous Emphysema / Q000175:diagnosis / Q000209:etiology*; D014057:Tomography, X-Ray Computed