title: Pneumomediastinum and subcutaneous emphysema caused by sigmoid diverticulum perforation secondary to blunt abdominal trauma: report of a case.
abstract: Pneumomediastinum and subcutaneous emphysema are very rare reported signs of colonic perforation most often associated with diverticulitis, toxic megacolon and colonoscopy. We report a case of a 60-year-old man with subcutaneous emphysema and pneumomediastinum, which developed three days after a car accident without pneumothorax. A computed tomography scan demonstrated perforation of a sigmoid diverticulum in conjunction with air. A laparotomy was performed and revealed a perforated sigmoid diverticulum, fistulized into the retroperitoneal cavity. We suspect that this diverticular perforation was caused by the deterioration of the sigmoid mesocolon secondary to the blunt abdominal trauma. To our knowledge, this is the first report in the literature about pneumomediastinum and subcutaneous emphysema caused by sigmoid diverticular rupture following mesosigmoid trauma.
authors.affiliation: Department of General Surgery, Eskişehir Osmangazi University, Faculty of Medicine, Eskişehir, Turkey. fatih_yasar@yahoo.com
authors.forename: Necdet Fatih
authors.initials: NF
authors.lastname: Yaşar
authors.forename: Mahmut
authors.initials: M
authors.lastname: Kebapçı
authors.forename: Enver
authors.initials: E
authors.lastname: Ihtiyar
mesh_terms: D000007:Abdominal Injuries / Q000150:complications*; D000063:Accidents, Traffic; D004239:Diverticulitis, Colonic / Q000150:complications; D004241:Diverticulum, Colon / Q000150:complications; D006801:Humans; D007416:Intestinal Perforation / Q000150:complications / Q000209:etiology*; D008297:Male; D008478:Mediastinal Emphysema / Q000175:diagnosis / Q000209:etiology*; D008875:Middle Aged; D012810:Sigmoid Diseases / Q000150:complications / Q000209:etiology*; D013352:Subcutaneous Emphysema / Q000175:diagnosis / Q000209:etiology*; D014949:Wounds, Nonpenetrating / Q000150:complications*