Yaşar Necdet Fatih, Kebapçı Mahmut, Ihtiyar Enver
Department of General Surgery, Eskişehir Osmangazi University, Faculty of Medicine, Eskişehir, Turkey.
Ulus Travma Acil Cerrahi Derg. 2011 Jan;17(1):93-5. doi: 10.5505/tjtes.2011.69783.
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.
纵隔气肿和皮下气肿是结肠穿孔非常罕见的报告体征，最常与憩室炎、中毒性巨结肠和结肠镜检查相关。我们报告一例60岁男性，出现皮下气肿和纵隔气肿，这是在一次无气胸的车祸三天后发生的。计算机断层扫描显示乙状结肠憩室穿孔并伴有气体。进行了剖腹手术，发现一个穿孔的乙状结肠憩室，瘘入腹膜后腔。我们怀疑这种憩室穿孔是由于腹部钝性创伤继发乙状结肠系膜恶化所致。据我们所知，这是文献中关于乙状结肠系膜创伤后乙状结肠憩室破裂导致纵隔气肿和皮下气肿的首例报告。
