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Open Access

Retroperitoneal perforation of the descending colon diverticulitis presenting with systemic emphysema

Kaori Kono, Kaori Ito, Yuko Sasajima, Yasufumi Miyake, Tetsuya Sakamoto
DOI: 10.1136/tsaco-2020-000606 Published 5 November 2020
Kaori Kono
1Division of Acute Care Surgery, Department of Emergency Medicine, Teikyo University School of Medicine, Tokyo, Japan
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Kaori Ito
1Division of Acute Care Surgery, Department of Emergency Medicine, Teikyo University School of Medicine, Tokyo, Japan
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Yuko Sasajima
2Department of Pathology, Teikyo University School of Medicine, Tokyo, Japan
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Yasufumi Miyake
1Division of Acute Care Surgery, Department of Emergency Medicine, Teikyo University School of Medicine, Tokyo, Japan
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Tetsuya Sakamoto
1Division of Acute Care Surgery, Department of Emergency Medicine, Teikyo University School of Medicine, Tokyo, Japan
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    Figure 1

    Chest radiograph shows pneumomediastinum (thin arrows), subcutaneous emphysema (thick arrows), and subdiaphragmatic free air (dashed arrows).

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    Figure 2

    CT of the chest and abdomen reveals subcutaneous emphysema (A–F), pneumomediastinum (A, B, C), pneumoperitoneum (C, D, E), pneumoretroperitoneum (C, D, E), and mesenteric emphysema (D, E).

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    Figure 3

    Macroscopically, the resected colon had scattered diverticula. The perforation was not visible in the mucosa (black circle in A). There is a deep insertion that seems to be perforation on the split surface of the specimen (arrow in B). There is a stool influx that may be macroscopically due to the perforation. It is conjectured that there was diverticulitis and associated perforation.

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Retroperitoneal perforation of the descending colon diverticulitis presenting with systemic emphysema
Kaori Kono, Kaori Ito, Yuko Sasajima, Yasufumi Miyake, Tetsuya Sakamoto
Trauma Surg Acute Care Open Nov 2020, 5 (1) e000606; DOI: 10.1136/tsaco-2020-000606

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Retroperitoneal perforation of the descending colon diverticulitis presenting with systemic emphysema
Kaori Kono, Kaori Ito, Yuko Sasajima, Yasufumi Miyake, Tetsuya Sakamoto
Trauma Surg Acute Care Open Nov 2020, 5 (1) e000606; DOI: 10.1136/tsaco-2020-000606
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Retroperitoneal perforation of the descending colon diverticulitis presenting with systemic emphysema
Kaori Kono, Kaori Ito, Yuko Sasajima, Yasufumi Miyake, Tetsuya Sakamoto
Trauma Surgery & Acute Care Open Nov 2020, 5 (1) e000606; DOI: 10.1136/tsaco-2020-000606
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