Related Experiment Video
Updated: Jun 19, 2026
The Pocket-Creation Procedure of Endoscopic Submucosal Dissection for Large Rectal Laterally Spreading Tumors
Published on: February 13, 2026
[Rectum tumor diagnosed by subcutaneous emphysema of the chest]
Nóra Hajdú1, Péter Zsoldos, György Neuberger
1Petz Aladár Megyei Oktató Kórház, Sebészeti Centrum, 9024 Gyor, Vasvári u. 2. kajda@freemail.hu
Background:
Various benign and malignant thoracic or abdominal diseases can cause subcutaneous emphysema on the chest, pneumomediastinum or pneumopericardium. To date only 7 cases have been reported on perforation of the sigmoid colon or the rectum presenting with these rare symptoms.
Methods:
We report a case of a 72-year-old woman who presented with thoracic and cervical subcutaneous emphysema, pneumomediastinum and pneumopericardium. Further examination revealed that this was caused by a rectal tumor causing large bowel obstruction and a consequent perforation of the transverse colon. Due to the patient's old age, poor health and the special anatomic situation after previous laparotomies, she presented with atypical symptoms.
Conclusions:
Subcutaneous emphysema of the chest, pneumomediastinum and pneumopericardium are uncommon symptoms and can be a real challenge in diagnosis. Especially in old patients with significant past medical history, life-threatening conditions present misleadingly with vague clinical symptoms. In case of these patients it is important to remember that even cardiopulmonary symptoms such as pneumomediastinum, pneumopericardium or subcutaneous emphysema of the chest can be signs of severe diseases in the abdomen.
