title: Pneumomediastinum as a complication of emphysematous cholecystitis: case report.
abstract: BACKGROUND
  Emphysematous cholecystitis is a variant of acute cholecystitis which is generally caused by gas-forming organisms. Emphysematous cholecystitis may cause gas spreading within the subcutaneous tissue, peritoneal cavity and retroperitoneum.
  
  
  METHODS
  We present a case of emphysematous cholecystitis in a middle-aged diabetic patient who, postoperatively, presented edema in both flanks and left chest crepitation on palpation, associated with hemodynamic worsening. Computed tomography scan of the chest and abdomen revealed a large pneumomediastinum, pneumoretroperitoneum, gas in subcutaneous tissue and flank abscesses. In both blood and surgical wound exudate cultures, Escherichia coli was found.
  
  
  CONCLUSIONS
  Emphysematous cholecystitis should be considered as a possible cause of pneumomediastinum.
authors.affiliation: Department of General Surgery, University Hospital of Canary Islands, Ofra s/n, La Cuesta, Santa Cruz de Tenerife, 38320, Spain.
authors.forename: Luciano
authors.initials: L
authors.lastname: Delgado-Plasencia
authors.forename: Ignacio
authors.initials: I
authors.lastname: González-García
authors.forename: Diana
authors.initials: D
authors.lastname: Rodríguez-González
authors.forename: Esther
authors.initials: E
authors.lastname: Torres-Monzón A
mesh_terms: D002763:Cholecystectomy; D003937:Diagnosis, Differential; D004322:Drainage; D041882:Emphysematous Cholecystitis / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D006801:Humans; D008297:Male; D008478:Mediastinal Emphysema / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D008875:Middle Aged; D014057:Tomography, X-Ray Computed
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