Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0034067 (emphysema)
 11,506 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We describe two cases of universal ulcerative colitis in which toxic megacolon was complicated by the unusual occurrence of air tracking retroperitoneally through the diaphragm and the mediastinum, without signs of free intraperitoneal air, and ultimately presenting as subcutaneous emphysema in the neck. Physicians should remain alert to this unusual presentation of air leakage from the colon in toxic ulcerative colitis, in order to appreciate the potential gravity of the situation.
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PMID:Toxic megacolon in ulcerative colitis complicated by pneumomediastinum: report of two cases. 742 17

Pneumomediastinum and subcutaneous emphysema are very rare reported signs of colonic perforation most often associated with diverticulitis, toxic megacolon and colonoscopy. We report a case of a 60-year-old man with subcutaneous emphysema and pneumomediastinum, which developed three days after a car accident without pneumothorax. A computed tomography scan demonstrated perforation of a sigmoid diverticulum in conjunction with air. A laparotomy was performed and revealed a perforated sigmoid diverticulum, fistulized into the retroperitoneal cavity. We suspect that this diverticular perforation was caused by the deterioration of the sigmoid mesocolon secondary to the blunt abdominal trauma. To our knowledge, this is the first report in the literature about pneumomediastinum and subcutaneous emphysema caused by sigmoid diverticular rupture following mesosigmoid trauma.
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PMID:Pneumomediastinum and subcutaneous emphysema caused by sigmoid diverticulum perforation secondary to blunt abdominal trauma: report of a case. 2134 Nov 44

A 19-year-old man with a 1-year history of ulcerative colitis presented with fever, bloody diarrhea and severe dehidration. He was on po.48 mg methylprednisolon and 3 g mesalazine daily, and has recently finished taking chlarythromycin for Campylobacter jejuni infection. On physical examination, no abdominal tenderness was found, but surprisingly, extensive bilateral subcutaneous emphysema was detected in the supraclavicular regions. Laboratory tests proved anaemia, elevated white blood cell count, thrombocyte count and CRP levels. Stool culture was negative. Chest X-ray and CT scan revealed pneumomediastinum and subcutaneous air on the neck spreading to the scapular regions. Besides blood transfusion, iv. cyclosporin therapy was initiated (200 mg/day) along with iv. methylprednisolon (1mg/kg/day) and iv. ceftriaxon (2 g/day). Stool frequency and bloody stools decreased remarkably within one week, and subcutaneous emphysema has resolved. Colonoscopy one week later revealed deep, extensive ulcerations in the transverse and descending colon without any sign of previous perforation. Cyclosporin and methylprednisolon was continued orally. Pneumomediastinum and subcutaneous emphysema in ulcerative colitis are unusual complications, typically linked to retroperitoneal colonic perforation or toxic megacolon, and are extremely rare without preceding endoscopic procedures. Except from two cases in the literature, conservative treatment with iv. antibiotics and steroids failed to save from urgent surgical procedure, resulting in a partial or total colectomy. In our case we were able to avoid urgent surgery by the immediate use of iv. cyclosporin in combination with iv. steroids and antibiotics, while the outcome of the bowel remains questionable in the next few months.
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PMID:"Ulcerative crepitus" -- a case with subcutaneous emphysema and pneumomediastinum without colonic perforation or toxic megacolon in ulcerative colitis successfully treated conservatively. 2239 71