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Pneumomediastinum as a complication of emphysematous cholecystitis: case report
Luciano Delgado-Plasencia1, Ignacio González-García, Diana Rodríguez-González
1Department of General Surgery, University Hospital of Canary Islands, Ofra s/n, La Cuesta, Santa Cruz de Tenerife, 38320, Spain.
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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