{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T11:10:05Z","timestamp":1756379405402,"version":"3.44.0"},"reference-count":12,"publisher":"BMJ","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Reports"],"accepted":{"date-parts":[[2014,9,16]]},"abstract":"<jats:p>An 83-year-old woman underwent an elective perineal proctosigmoidectomy (Altemeier procedure) for a rectal prolapse. On postoperative day 1, the patient presented with impressive subcutaneous emphysema involving the chest, neck and face without any other symptoms. A CT scan showed free air in the retroperitoneum, the intraperitoneal cavity, the mediastinum and a subcutaneous emphysema of the neck and the face. Air was also found around the coloanal anastomosis and an anastomotic leak was proven by rectal contrast agent. In this situation, a rectoscopy followed by a laparoscopy were immediately performed. The leak could not be visualised. Peritoneal lavage and drainage, followed by protective sigmoidostomy were carried out. After surgery, the follow-up was uneventful except a persistent but asymptomatic leak with a presacral cavity. The coloanal dehiscence was later proven in rectoscopy. Although sutured, it is still present and colostomy closure will eventually be possible in a few months.<\/jats:p>","DOI":"10.1136\/bcr-2014-206257","type":"journal-article","created":{"date-parts":[[2014,10,7]],"date-time":"2014-10-07T07:58:08Z","timestamp":1412668688000},"page":"bcr2014206257","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Massive surgical emphysema after perineal proctosigmoidectomy"],"prefix":"10.1136","volume":"2014","author":[{"given":"Fiorenzo Valente Ernst Jakob","family":"Angehrn","sequence":"first","affiliation":[{"name":"Department of Surgery, H\u00f4pital du Jura\u2014Site de Del\u00e9mont, Del\u00e9mont, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Silvio","family":"D\u00e4ster","sequence":"additional","affiliation":[{"name":"Department of Surgery, University Hospital Basel, Basel, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marius","family":"Antonescu","sequence":"additional","affiliation":[{"name":"Department of Surgery, H\u00f4pital du Jura\u2014Site de Del\u00e9mont, Del\u00e9mont, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2014,10,7]]},"reference":[{"key":"2025082803332218000_2014.oct07_1.bcr2014206257.1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.c7099"},{"key":"2025082803332218000_2014.oct07_1.bcr2014206257.2","doi-asserted-by":"publisher","DOI":"10.2214\/ajr.169.6.9393164"},{"key":"2025082803332218000_2014.oct07_1.bcr2014206257.3","doi-asserted-by":"publisher","DOI":"10.1097\/01.grf.0000170428.45819.4e"},{"key":"2025082803332218000_2014.oct07_1.bcr2014206257.4","doi-asserted-by":"publisher","DOI":"10.1001\/archsurg.1952.01260020084007"},{"key":"2025082803332218000_2014.oct07_1.bcr2014206257.5","first-page":"24","article-title":"Rectal prolapse: a 10-year experience","volume":"7","author":"Hammond","year":"2007","journal-title":"Ochsner J"},{"key":"2025082803332218000_2014.oct07_1.bcr2014206257.6","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.1984.00350190143024"},{"key":"2025082803332218000_2014.oct07_1.bcr2014206257.7","doi-asserted-by":"publisher","DOI":"10.4236\/ijcm.2010.12015"},{"key":"2025082803332218000_2014.oct07_1.bcr2014206257.8","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.1800800923"},{"key":"2025082803332218000_2014.oct07_1.bcr2014206257.9","doi-asserted-by":"publisher","DOI":"10.4321\/S1130-01082012000700014"},{"key":"2025082803332218000_2014.oct07_1.bcr2014206257.10","first-page":"3139","article-title":"Perirectal, retroperitoneal, intraperitoneal and mediastinal gas after stapled haemorrhoidopexy","volume":"168","author":"Halberg","year":"2006","journal-title":"Ugeskr Laeger"},{"key":"2025082803332218000_2014.oct07_1.bcr2014206257.11","doi-asserted-by":"crossref","first-page":"pii: bcr0920114822","DOI":"10.1136\/bcr.09.2011.4822","article-title":"An unusual case of rectal perforation resulting in extensive surgical emphysema","volume":"2012","author":"Lee","year":"2012","journal-title":"BMJ Case Rep"},{"key":"2025082803332218000_2014.oct07_1.bcr2014206257.12","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0b013e3181c1b0d1"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2014-206257","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T10:33:29Z","timestamp":1756377209000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2014-206257"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2014,10,7]]},"references-count":12,"alternative-id":["10.1136\/bcr-2014-206257"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2014-206257","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2014,10,7]]}}}