EURORAD ESR

Case 9044

Atypical clinical presentation of perforated sigmoid diverticulitis simulating a thoracic pathology

Author(s)
Bresciani P, Chizzolini F. Azienda Ospedaliero-Universitaria di Parma, Parma, Italy
 
Patient
male, 60 year(s)
 
 
  • Figure 1
    Initial chest x-ray

    Bilateral subcutaneous emphysema of the neck & pneumomediastinum.

     
    Area of Interest: Thorax; Imaging Technique: Digital radiography;
     
     
  • Figure 2
    Chest CT scan. Axial sections
     

    Bilateral subcutaneous emphysema of the neck.

     
    Area of Interest: Thorax; Imaging Technique: CT;

    Bilateral pneumomediastinum

     
    Area of Interest: Mediastinum; Imaging Technique: CT;

    Bilateral pneumoretroperitoneum extending into anterior abdominal wall.

     
    Area of Interest: Abdomen; Imaging Technique: CT;
     
     
  • Figure 3
    Single contrast enema (with gastrografin)

    Multiple diverticula in the descending and sigmoid colon. Eccentric luminal narrowing of the sigmoid colon with thickening of the haustral folds and mucosal tethering. Extraluminal contrast material due to perforation...

     
    Area of Interest: Abdomen; Imaging Technique: Plain radiographic studies;
     
     
  • Figure 4
    Abdominal CT scan
     

    Descending colon (arrow) and large amount of extraluminal contrast material in the retroperotoneum secondary to perforation in the sigmoid colon.

     
    Area of Interest: Abdomen; Imaging Technique: CT;

    Descending colon (arrow) and large amount of extraluminal contrast material in the retroperotoneum secondary to perforation in the sigmoid colon.

     
    Area of Interest: Abdomen; Imaging Technique: CT;
     
     
Bilateral subcutaneous emphysema of the neck & pneumomediastinum.
 
Bilateral subcutaneous emphysema of the neck.
 
Bilateral pneumomediastinum
 
Bilateral pneumoretroperitoneum extending into anterior abdominal wall.
 
Multiple diverticula in the descending and sigmoid colon. Eccentric luminal narrowing of the sigmoid colon with thickening of the haustral folds and mucosal tethering. Extraluminal contrast material due to perforation of the sigmoid colon.
 
Descending colon (arrow) and large amount of extraluminal contrast material in the retroperotoneum secondary to perforation in the sigmoid colon.
 
Descending colon (arrow) and large amount of extraluminal contrast material in the retroperotoneum secondary to perforation in the sigmoid colon.
 
 
 
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