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  • Title: Pneumomediastinum as a complication of emphysematous cholecystitis: case report.
    Author: Delgado-Plasencia L, González-García I, Rodríguez-González D, Torres-Monzón A E.
    Journal: BMC Gastroenterol; 2010 Sep 02; 10():99. PubMed ID: 20813063.
    Abstract:
    BACKGROUND: Emphysematous cholecystitis is a variant of acute cholecystitis which is generally caused by gas-forming organisms. Emphysematous cholecystitis may cause gas spreading within the subcutaneous tissue, peritoneal cavity and retroperitoneum. CASE PRESENTATION: We present a case of emphysematous cholecystitis in a middle-aged diabetic patient who, postoperatively, presented edema in both flanks and left chest crepitation on palpation, associated with hemodynamic worsening. Computed tomography scan of the chest and abdomen revealed a large pneumomediastinum, pneumoretroperitoneum, gas in subcutaneous tissue and flank abscesses. In both blood and surgical wound exudate cultures, Escherichia coli was found. CONCLUSION: Emphysematous cholecystitis should be considered as a possible cause of pneumomediastinum.
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