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Case Reports
. 2023 Feb 23;17(1):137-142.
doi: 10.1159/000529282. eCollection 2023 Jan-Dec.

Retroperitoneal and Mediastinal Emphysema after Sigmoid Colon Resection

Ryusei Yamamoto  1 , Katsushi Yoshida  1 , Masataka Ando  1 , Yoshitaka Toyoda  1 , Aya Tanaka  1 , Kenji Kato  1 , Ryuzo Yamaguchi  1
Affiliations
Case Reports

Retroperitoneal and Mediastinal Emphysema after Sigmoid Colon Resection

Ryusei Yamamoto et al. Case Rep Gastroenterol. .

Abstract

Retroperitoneal and mediastinal emphysema after colon resection is extremely rare, especially in the absence of anastomotic leakage. The feasibility and safety of conservative treatment for this complication are unknown. We report a patient who underwent open sigmoid colon resection for colon cancer and developed retroperitoneal and mediastinal emphysema that was not caused by anastomotic leakage. Retroperitoneal and mediastinal emphysema occurred as a result of diverticular perforation. We were able to treat this patient successfully with conservative management.

Keywords: Colorectal surgery; Diverticulum; Emphysema; Mediastinum; Retroperitoneum.

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Conflict of interest statement

The authors have no competing interests to declare.

Figures

Fig. 1.
Fig. 1.
Computed tomography on postoperative day 3 shows mediastinal emphysema (a), retroperitoneal emphysema around the pancreas (b), retroperitoneal emphysema at the dorsal descending colon (c), but no fluid or air collections around the anastomosis (d). Arrows: areas of subcutaneous, retroperitoneal, and mediastinal emphysema. Arrowhead: area of the anastomosis.
Fig. 2.
Fig. 2.
Computed tomography on postoperative day 23 shows resolution of the mediastinal emphysema (a), resolution of the retroperitoneal emphysema around the pancreas (b), and development of localized fluid and air collections in the retroperitoneum, contiguous with the descending colon (c). Arrow: area of the fluid and air collections in the retroperitoneum. Arrowhead: area of the continuity with the descending colon and fluid and air collections in the retroperitoneum.
Fig. 3.
Fig. 3.
Preoperative computed tomography shows a diverticulum of the descending colon, corresponding to the site of postoperative perforation. Arrow: diverticulum.
See this image and copyright information in PMC

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