Fox T A, Gomez J, Bravo J
Dis Colon Rectum. 1978 Jul-Aug;21(5):357-60. doi: 10.1007/BF02586667.
Two cases of subcutaneous emphysema of the left lower extremity secondary to perforations of the rectum ,nd sigmoid colon are presented. Although this is an extremely rare syndrome, the true incidence is probably higher, as some cases will be misdiagnosed as gas gangrene unless careful clinical and postmortem examinations are performed. Only rapid recognition of the probable origin of the gas, coupled with aggressive, definitive therapy, can prevent the usually fatal course of this condition. In the absence of trauma to the chest or infection in a previously normal leg, subcutaneous emphysema of a limb should alert the physician to the possibility of a gastrointestinal perforation as a source of the gas. Perforations of the gastrointestinal tract into the subcutaneous tissue can occur anywhere from the neck to the lower extremities.
本文报告两例因直肠和乙状结肠穿孔继发左下肢皮下气肿的病例。尽管这是一种极为罕见的综合征，但实际发病率可能更高，因为有些病例若不进行仔细的临床和尸检，会被误诊为气性坏疽。只有迅速识别气体的可能来源，并采取积极、明确的治疗措施，才能防止这种疾病通常致命的病程发展。在没有胸部外伤或既往正常的下肢感染的情况下，肢体的皮下气肿应提醒医生注意胃肠道穿孔作为气体来源的可能性。胃肠道向皮下组织的穿孔可发生于从颈部到下肢的任何部位。
