Kageyama Hiroshi
Department of Neurosurgery (Spinal surgery), Shin-Kuki General Hospital, Kamihayami 418-1, Kuki, Saitama, Japan.
Radiol Case Rep. 2024 Jul 24;19(10):4280-4282. doi: 10.1016/j.radcr.2024.06.075. eCollection 2024 Oct.
Spinal pneumorrhachis is a relatively rare condition. Herein, we describe a case of whole spinal pneumorrhachis. A 68-year-old male, with a history of total proctocolectomy due to ulcerative colitis, had fever, diarrhea, and inflammatory reactions. Computed tomography (CT) revealed extensive epidural pneumorrhachis in the spinal canal from the cervical to sacral vertebrae. The patient was diagnosed with perforation of the rectal anastomosis and retroperitoneal abscess. Antibiotics were administered, and the abscess cavity was reduced on the follow-up CT. Pneumorrhachis in the spinal canal is often found only in the cervical, thoracic, or lumbar regions and is rarely found in the entire spinal canal. Spinal pneumorrhachis resulting from perforation of the colon or rectum has only been reported in 6 previous cases. To differentiate diseases that cause pneumorrhachis in the spinal canal, retroperitoneal abscess, and emphysema associated with perforation of the colon and rectum should be considered.
脊髓积气是一种相对罕见的病症。在此，我们描述一例全脊髓积气的病例。一名68岁男性，有因溃疡性结肠炎行全直肠结肠切除术史，出现发热、腹泻及炎症反应。计算机断层扫描（CT）显示从颈椎至骶椎的椎管内广泛硬膜外积气。该患者被诊断为直肠吻合口穿孔及腹膜后脓肿。给予抗生素治疗，随访CT显示脓肿腔缩小。椎管内积气通常仅见于颈椎、胸椎或腰椎区域，很少见于整个椎管。由结肠或直肠穿孔导致的脊髓积气此前仅报道过6例。为鉴别引起椎管内积气的疾病，应考虑腹膜后脓肿以及与结肠和直肠穿孔相关的气肿。
