title: Subcutaneous emphysema, pneumopericardium, pneumomediastinum and pneumoretroperitoneum secondary to sigmoid perforation: a case report.
abstract: A 50-year-old woman presented with chronic epigastric abdominal pain and constipation. She underwent diagnostic upper and lower endoscopy for further evaluation. Several hours following the procedure, she developed chest and subcutaneous emphysema of her upper chest, neck, and face. A chest X-ray demonstrated marked subcutaneous emphysema, pneumopericardium, and pneumomediastinum. A CT scan revealed a small leak at the rectosigmoid junction. Because the patient did not have peritoneal signs, she was treated conservatively and discharged on hospital day seven. The complications of both esohagogastroduodenoscoy, and colonoscopy are discussed, with an emphasis on perforations.
authors.affiliation: Department of Surgery, John A. Burns School of Medicine, University of Hawai'i, Honolulu, 96813, USA. dmurariu@yahoo.com
authors.forename: Daniel
authors.initials: D
authors.lastname: Murariu
authors.forename: Brent K
authors.initials: BK
authors.lastname: Tatsuno
authors.forename: Michael K
authors.initials: MK
authors.lastname: Tom
authors.forename: Jae S
authors.initials: JS
authors.lastname: You
authors.forename: Gregorio
authors.initials: G
authors.lastname: Maldini
mesh_terms: D015746:Abdominal Pain / Q000175:diagnosis; D016099:Endoscopy, Gastrointestinal / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007416:Intestinal Perforation / Q000150:complications* / Q000209:etiology; D008478:Mediastinal Emphysema / Q000000981:diagnostic imaging / Q000209:etiology*; D008875:Middle Aged; D011026:Pneumopericardium / Q000000981:diagnostic imaging / Q000209:etiology*; D011859:Radiography; D012188:Retropneumoperitoneum / Q000000981:diagnostic imaging / Q000209:etiology*; D013352:Subcutaneous Emphysema / Q000000981:diagnostic imaging / Q000209:etiology*; D057832:Watchful Waiting