title: Pneumomediastinum and pneumoretroperitoneum: an extremely rare presentation of acute appendicitis.
abstract: A 22-year-old woman presented with abdominal pain for 12 days. On examination, the abdomen was slightly distended and painful to palpation in the right flank. Subsequent abdominal imaging showed inflammation in the right iliac fossa, retroperitoneal air pockets with inflammation, and signs of pneumomediastinum. Exploratory laparotomy revealed a perforated retrocaecal appendix with abscess extending to the retroperitoneum. Surgical intervention involved a right hemicolectomy followed by end-to-side anastomosis of the ileum to the transverse colon. Histopathological examination of the resected specimen revealed intense inflammation of the caecum and no signs of malignancy. The patient was discharged in good condition 54 days after surgery.
authors.affiliation: Department of General Surgery, Universidade Federal de Mato Grosso do Sul (UFMS), Campo Grande, MS, Brazil.
authors.forename: Caroline Sauter
authors.initials: CS
authors.lastname: Dalbem
authors.affiliation: Department of Clinical Radiology, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil.
authors.forename: Thiago Franchi
authors.initials: TF
authors.lastname: Nunes
authors.affiliation: Hospital Universitário of UFMS, Campo Grande, MS, Brazil.
authors.forename: Magali da Silva Sanches
authors.initials: Mda S
authors.lastname: Machado
authors.affiliation: Department of Diagnostic Imaging, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil.
authors.forename: Suzan Menasce
authors.initials: SM
authors.lastname: Goldman
mesh_terms: D015746:Abdominal Pain / Q000209:etiology; D000038:Abscess / Q000175:diagnosis / Q000601:surgery; D000208:Acute Disease; D001064:Appendicitis / Q000175:diagnosis* / Q000601:surgery; D003082:Colectomy / Q000379:methods; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008478:Mediastinal Emphysema / Q000209:etiology* / Q000601:surgery; D012188:Retropneumoperitoneum / Q000209:etiology* / Q000601:surgery; D016896:Treatment Outcome; D055815:Young Adult