Rees Jonathan Richard, Burgess Phillip
Gloucestershire Royal Hospital, Colorectal Surgery, Great Western Road, Gloucester GL1 3NN, UK.
BMJ Case Rep. 2009;2009. doi: 10.1136/bcr.03.2009.1692. Epub 2009 Oct 5.
Diverticular disease is very common and may cause symptoms of psoas irritation because of contiguous inflammation arising from the colon affecting the retroperitoneum. Retroperitoneal perforation is rare and is marked by free gas in the adjacent musculature. Rarely infection and associated gas may track into the lower limbs; however, if adequate drainage can be achieved, surgery in the unfit may be avoided. We present a case of a 79-year-old woman with retroperitoneal perforation of diverticular disease presenting with free gas in the leg musculature that was managed conservatively because of associated comorbidities and was associated with the formation of a cutaneous faecal fistula in the lower limb.
憩室病非常常见，可能因结肠炎症蔓延至腹膜后间隙而导致腰大肌刺激症状。腹膜后穿孔很少见，其特征是邻近肌肉组织中有游离气体。感染及相关气体很少会蔓延至下肢；然而，如果能够实现充分引流，可不进行不适宜手术者的手术。我们报告一例79岁女性憩室病腹膜后穿孔病例，该患者腿部肌肉组织中有游离气体，因合并其他疾病而采用保守治疗，且伴有下肢皮肤粪瘘形成。
