title: Subcutaneous emphysema: a rare manifestation of a perforated diverticulitis in a patent inguinal canal.
abstract: 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.
authors.affiliation: Internal Medicine Department, University Hospital Geneva, Rue Micheli-Du-Crest 24, 1211, Geneva 14, Switzerland.
authors.forename: Lambert
authors.initials: L
authors.lastname: de Vries
authors.forename: Anne-Sophie
authors.initials: AS
authors.lastname: Knoepfli
authors.forename: Philippe
authors.initials: P
authors.lastname: Konstantinidis
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Charbonney
mesh_terms: 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