CC-BY 4.0 · Surg J 2018; 04(01): e7-e13
DOI: 10.1055/s-0038-1624563
Review Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Anatomical and Radiological Considerations When Colonic Perforation Leads to Subcutaneous Emphysema, Pneumothoraces, Pneumomediastinum, and Mediastinal Shift

Sala Abdalla
Departments of General Surgery and Radiology, King's College Hospital NHS Foundation Trust, London, United Kingdom
,
Rupinder Gill
Departments of General Surgery and Radiology, King's College Hospital NHS Foundation Trust, London, United Kingdom
,
Gibran Timothy Yusuf
Departments of General Surgery and Radiology, King's College Hospital NHS Foundation Trust, London, United Kingdom
,
Rosaria Scarpinata
Departments of General Surgery and Radiology, King's College Hospital NHS Foundation Trust, London, United Kingdom
› Author Affiliations
Further Information

Publication History

22 September 2017

18 December 2017

Publication Date:
22 February 2018 (online)

Abstract

While colonoscopy is generally regarded as a safe procedure, colonic perforation can occur and the risk of this is higher when interventional procedures are undertaken. The presentation may be acute or delayed depending on the extent of the perforation. Extracolonic gas following colonic perforation can migrate to several body compartments that are embryologically related and it has previously been reported in the thorax, mediastinum, neck, scrotum, and lower limbs. This review discusses in detail the anatomical pathways that led to a rare case of widespread subcutaneous emphysema, bilateral pneumothoraces, pneumomediastinum, and mediastinal shift from colonic perforation during a diagnostic colonoscopy. This is further supported by a description of the radiological images.