Subcutaneous cervical emphysema and pneumomediastinum due to a diastatic rupture of the cecum

Vecchio, Rosario

doi:10.11138/gchir/2015.36.6.272

Cited by 3 publications

(4 citation statements)

References 21 publications

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“…PM occurs via the Macklin effect, as explained above. Due to the continuity of the mediastinal and neck fascia, free air can move to the subcutaneous area or peripheral to the subpleural region, causing PM-subcutaneous emphysema and PT, respectively [ 9 ]. Sometimes the coexistence of these three entities can be detected.…”

Section: Discussionmentioning

confidence: 99%

The analysis of pleural complications of COVID-19 pneumonia

Türk¹,

Akarsu²,

Tombul³

et al. 2021

Turk J Med Sci

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Section: Discussionmentioning

confidence: 99%

The analysis of pleural complications of COVID-19 pneumonia

Türk¹,

Akarsu²,

Tombul³

et al. 2021

Turk J Med Sci

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“…Causes of cervical emphysema and pneumomediastinum have been reported, including dental surgery [ 14 , 15 ], mastoid fracture due to baseball injury [ 16 ], diastatic rupture of the cecum [ 17 ], and acute perforated diverticulitis [ 18 ]. Various patients received prophylactic antibiotic therapy [ 15 ].…”

Section: Discussionmentioning

confidence: 99%

Cervical Emphysema and Pneumomediastinum Caused by a Nasogastric Tube: A Case Report

et al. 2023

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Unusual clinical course Background:The nasogastric tube (NGT) is a common medical device, and serious complications associated with NGT insertions are rare. The most common serious complication is tracheal insertion; cervical emphysema and pneumomediastinum are rare. There are several methods for confirming the location of the NGT, but a single method of confirmation is often inadequate. Confirmation by air insufflation into the NGT is currently not recommended and is highly invasive. Here, we report a case of cervical emphysema and pneumomediastinum caused by an NGT. Case Report:A 94-year-old woman experienced a stroke and was hospitalized for neurosurgery. The nurse inserted an NGT and performed insufflation, but air sounds were not detected. Chest radiography did not reveal the tip of the NGT. Computed tomography (CT) revealed cervical emphysema, pneumomediastinum, an NGT bent in the esophagus, and the distal end of the NGT in the nasopharynx. Nasopharyngeal endoscopy revealed damaged nasopharyngeal mucosa and the distal end of the NGT. The patient was diagnosed with insufflated air passing through the damaged nasopharynx, which had spread to the cervical area and mediastinum. The NGT was removed, and the patient was treated with antibiotics. CT showed cervical emphysema, and the pneumomediastinum resolved after 20 days. Conclusions:It is important to recognize that there are numerous serious and unexpected complications associated with NGT. Different methods should be considered and used to confirm the location of an NGT. Further studies on the confirmation methods and dissemination of such knowledge are required to reduce NGT complications.

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“…aureus, E. coli, Bacteroides species, or other rare bacteria, such as the Actinomyces species [16]. Since cecum (in the case of distal obstructing cancer) usually perforates most often on the anterior longitudinal axis [13], it is not surprising that there is only one more case report of a retroperitoneal diastatic cecal perforation, which manifested however as subcutaneous cervical emphysema and pneumomediastinum, and not as a retroperitoneal abscess [17].…”

Section: Case Reports In Surgerymentioning

confidence: 99%

“…In our case, drainage of the retroperitoneal space was also necessary for damage control. If the patient's situation permits, removal of the primary tumor following the principles of surgical oncology may be contemplated during the index surgery, provided however that there is no distant metastasis [17].…”

Section: Case Reports In Surgerymentioning

confidence: 99%

Retroperitoneal Cecal Perforation Resulting from Obstructive Ascending Colon Adenocarcinoma

Paramythiotis

Karakatsanis

Moysidis

et al. 2020

Case Reports in Surgery

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Most colorectal cancer patients in the early stages of the disease do not display any alarming symptoms. A total percentage of 9-27% of colorectal cancer patients present with acute abdomen, bowel obstruction, perforation, or bleeding. Perforation as the first presentation of the disease is seen in no more than 2.6-10% of patients. Intestinal perforation may be found on either the site of the tumor or on a more proximal site, caused by distention of the bowel due to peripheral obstruction. This is a case of a 75-year-old female patient who presents in the emergency department with retroperitoneal cecal perforation due to an obstructing tumor of the ascending colon. She underwent an emergency right hemicolectomy and washout of the retroperitoneal space. The cecum is not an unusual site of distention and subsequent perforation in the case of colonic obstruction, especially in the presence of a competent ileocecal valve. While the mechanism of diastatic cecal perforation is well described, it is the first time in the literature that this does not occur on the anterior surface of the organ. In our case, cecal perforation presents as a retroperitoneal abscess without peritoneal spillage. Nonetheless, it still carries a grim prognosis and urgent surgical intervention is needed.

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Subcutaneous cervical emphysema and pneumomediastinum due to a diastatic rupture of the cecum

Cited by 3 publications

References 21 publications

The analysis of pleural complications of COVID-19 pneumonia

The analysis of pleural complications of COVID-19 pneumonia

Cervical Emphysema and Pneumomediastinum Caused by a Nasogastric Tube: A Case Report

Retroperitoneal Cecal Perforation Resulting from Obstructive Ascending Colon Adenocarcinoma

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