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["Disappearance" of retroperitoneal vessels - a case report]
E Oschatz1, G Strasser, E Schober
1Institut für Röntgendiagnostik, Sozialmedizinisches Zentrum Baumgartner Höhe, Otto-Wagner Spital mit Pflegezentrum, Wien. Elisabeth.oschatz@wienkav.at
Ultraschall in Der Medizin (Stuttgart, Germany : 1980)
|December 6, 2003
Summary
Pneumo-retroperitoneum, or air in the retroperitoneum, presents unique ultrasound challenges. Recognizing characteristic sonographic findings is crucial for timely diagnosis and treatment of this rare condition.
Area of Science:
- Radiology
- Gastroenterology
Background:
- Pneumo-retroperitoneum is a rare condition characterized by the presence of free air in the retroperitoneal space.
- Prompt diagnosis is essential for appropriate management and to prevent complications.
Observation:
- A 74-year-old patient presented with dyspnea and later developed severe abdominal pain.
- Abdominal ultrasound revealed significant reverberation artifacts in the retroperitoneum, hindering visualization of abdominal organs.
- Plain radiography confirmed free retroperitoneal and intraabdominal gas.
Findings:
- The case highlights the sonomorphologic features of pneumo-retroperitoneum, including the presence of reverberation artifacts.
- Perforated diverticulitis of the sigma was identified as the cause of the pneumo-retroperitoneum.
- A concurrent malignant mesothelioma was diagnosed as the cause of recurrent pleural effusion.
Implications:
- Awareness of characteristic ultrasound findings in pneumo-retroperitoneum is critical for accurate diagnosis.
- Early recognition of retroperitoneal air aids in initiating prompt and appropriate therapeutic interventions.
- This case underscores the importance of considering diverse etiologies, including malignancy, in patients with unexplained symptoms and imaging findings.