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Bowel Perforation Presenting as Head and Neck Subcutaneous Emphysema
Dezarae R Leto1, Derek T Clar2, David A Goodman3
1General Surgery Resident, Cape Fear Valley Medical Center, Fayetteville, NC, USA.
The American Surgeon
|February 17, 2021
Summary
A patient with Crohn's disease developed subcutaneous emphysema after endoscopic balloon dilatation for an ileocolic stricture. This rare complication indicated a perforated bowel, requiring surgical intervention and leading to a full recovery.
Area of Science:
- Gastroenterology
- Surgical complications
- Medical imaging
Background:
- Crohn's disease is a chronic inflammatory bowel disease.
- Ileocolic strictures are common complications of Crohn's disease.
- Endoscopic balloon dilatation is a treatment option for strictures.
Purpose of the Study:
- To report a rare case of subcutaneous emphysema following endoscopic balloon dilatation for Crohn's disease.
- To highlight the association between subcutaneous emphysema and bowel perforation.
- To discuss the clinical presentation and management of this complication.
Main Methods:
- Case report of a patient with Crohn's disease.
- Review of clinical presentation and diagnostic imaging (e.g., CT scan).
- Description of surgical intervention (laparotomy and bowel resection).
Main Results:
- The patient developed subcutaneous emphysema of the face, neck, and chest wall post-procedure.
- Clinical evaluation and imaging confirmed peritonitis due to a perforated bowel.
- Successful surgical management and recovery.
Conclusions:
- Subcutaneous emphysema in the head and neck can be a rare presentation of viscus perforation.
- Prompt diagnosis and surgical intervention are crucial for managing bowel perforation.
- Endoscopic procedures, while beneficial, carry inherent risks that require careful consideration.
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