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A precordial rub in a boy with a severe attack of ulcerative colitis

Laura Badina1, Giovanna Ferrara, Pierpaolo Guastalla

  • 1From the *Institute for Maternal and Child Health-IRCCS, Burlo Garofolo, and †University of Trieste, Trieste, Italy.

Pediatric Emergency Care
|April 4, 2014
PubMed

Insights

Pneumomediastinum, a rare complication of ulcerative colitis, can mimic pericarditis. This case highlights the importance of considering this condition in patients with severe ulcerative colitis and related symptoms.

Area of Science:

  • Gastroenterology
  • Cardiology
  • Radiology

Background:

  • Ulcerative colitis (UC) is a chronic inflammatory bowel disease.
  • Severe UC exacerbations can lead to rare complications.
  • Toxic megacolon is a known severe complication of UC.

Observation:

  • A pediatric case presented with symptoms suggestive of pericarditis.
  • Diagnostic imaging revealed pneumomediastinum.
  • The patient had an underlying diagnosis of ulcerative colitis.

Findings:

  • Pneumomediastinum was identified as a complication of ulcerative colitis.
  • The pneumomediastinum mimicked the clinical presentation of pericarditis.
  • An occult perforation secondary to ulcerative colitis was the likely cause.

Implications:

  • Pneumomediastinum should be included in the differential diagnosis for patients with severe ulcerative colitis presenting with chest symptoms.
  • Early recognition of this rare complication can guide appropriate management.
  • This case underscores the diverse gastrointestinal and extraintestinal manifestations of ulcerative colitis.

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