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Retroperitoneal perforation in ulcerative colitis with mediastinal and subcutaneous emphysema
J F Alvares1, P S Dhawan, S Tibrewala
1Department of Gastroenterology, BYL Nair Ch Hospital, Bombay, India.
Journal of Clinical Gastroenterology
|December 31, 1997
Summary
Retroperitoneal colonic perforation is a rare complication of ulcerative colitis. Conservative management of this condition, even with associated emphysema, can lead to successful outcomes.
Area of Science:
- Gastroenterology
- Colorectal Surgery
- Internal Medicine
Background:
- Ulcerative colitis (UC) is a chronic inflammatory bowel disease.
- Retroperitoneal colonic perforation is an uncommon but serious complication of UC.
- Toxic dilatation is a known risk factor for perforation in UC.
Observation:
- A case of severe UC with retroperitoneal colonic perforation is presented.
- The patient exhibited mediastinal and subcutaneous emphysema without toxic dilatation.
- This presentation is unusual compared to previously reported cases.
Findings:
- Conservative treatment was initiated, including intravenous fluids, parenteral nutrition, hydrocortisone, and antibiotics.
- The patient's condition improved without surgical intervention.
- Complete resolution of retroperitoneal air, mediastinal, and subcutaneous emphysema was observed within two weeks.
Implications:
- Conservative management may be a viable option for selected UC patients with retroperitoneal colonic perforation.
- This case highlights the importance of considering non-surgical approaches in specific clinical scenarios.
- Further research may explore the efficacy of conservative treatment for UC-related perforations.