Pneumomediastinum as a complication of emphysematous cholecystitis: case report.
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.
Delgado-Plasencia
Luciano
L
Department of General Surgery, University Hospital of Canary Islands, Ofra s/n, La Cuesta, Santa Cruz de Tenerife, 38320, Spain.
González-García
Ignacio
I
Rodríguez-González
Diana
D
Torres-Monzón A
Esther
E
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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