Perforated cecal carcinoma presenting as thigh emphysema

Gastrointestinal perforation into the retroperitoneum may present as thigh emphysema. In the elderly, abdominal symptoms may be minimal. We report a patient with a perforated cecal carcinoma presenting as right hip pain with thigh emphysema. A diagnosis of perforated intra-abdominal viscus was suspected from the radiographs. The patient initially did well after surgery, which included a hemicolectomy and debridement of necrotic muscle down to the knee. He later succumbed from cardiac arrest following a dyspneic episode.