{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,4]],"date-time":"2025-12-04T10:07:48Z","timestamp":1764842868167,"version":"3.37.3"},"reference-count":8,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,4,17]],"date-time":"2024-04-17T00:00:00Z","timestamp":1713312000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,4,17]],"date-time":"2024-04-17T00:00:00Z","timestamp":1713312000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Med Case Reports"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Gas extravasation complications arising from perforated diverticulitis are common but manifestations such as pneumoperitoneum, pneumoretroperitoneum, and pneumomediastinum happening at the same time are exceedingly rare. This case report explores the unique presentation of these 3 complications occurring simultaneously, their diagnosis and their management, emphasizing the importance of interdisciplinary collaboration for accurate diagnosis and effective management.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Case presentation<\/jats:title>\n                <jats:p>A 74-year-old North African female, with a medical history including hypertension, dyslipidemia, type 2 diabetes, goiter, prior cholecystectomy, and bilateral total knee replacement, presented with sudden-onset pelvic pain, chronic constipation, and rectal bleeding. Clinical examination revealed hemodynamic instability, hypoxemia, and diffuse tenderness. After appropriate fluid resuscitation with norepinephrine and saline serum, the patient was stable enough to undergo computed tomography scan. Emergency computed tomography scan confirmed perforated diverticulitis at the rectosigmoid junction, accompanied by the unprecedented presence of pneumoperitoneum, pneumoretroperitoneum, and pneumomediastinum. The patient underwent prompt surgical intervention with colo-rectal resection and a Hartmann colostomy. The postoperative course was favorable, leading to discharge one week after admission.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>This case report highlights the clinical novelty of gas extravasation complications in perforated diverticulitis. The unique triad of pneumoperitoneum, pneumoretroperitoneum, and pneumomediastinum in a 74-year-old female underscores the diagnostic challenges and the importance of advanced imaging techniques. The successful collaboration between radiologists and surgeons facilitated a timely and accurate diagnosis, enabling a minimally invasive surgical approach. This case contributes to the understanding of atypical presentations of diverticulitis and emphasizes the significance of interdisciplinary teamwork in managing such rare manifestations.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s13256-024-04488-1","type":"journal-article","created":{"date-parts":[[2024,4,17]],"date-time":"2024-04-17T00:01:50Z","timestamp":1713312110000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Pneumoperitoneum, pneumoretroperitoneum and pneumomediastinum: rare complications of perforation peritonitis: a case report"],"prefix":"10.1186","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3198-1783","authenticated-orcid":false,"given":"H.","family":"Hafiani","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"N.","family":"Bouknani","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"E. M.","family":"Choukri","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R. Charif","family":"Saibari","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A.","family":"Rami","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2024,4,17]]},"reference":[{"key":"4488_CR1","first-page":"1","volume":"2014","author":"S Fosi","year":"2014","unstructured":"Fosi S, Giuricin V, Girardi V, Di Caprera E, Costanzo E, Di Trapano R, et al. Subcutaneous emphysema, pneumomediastinum, pneumoretroperitoneum, and pneumoscrotum: unusual complications of acute perforated diverticulitis. Case Rep Radiol. 2014;2014:1\u20135.","journal-title":"Case Rep Radiol"},{"issue":"1","key":"4488_CR2","doi-asserted-by":"publisher","first-page":"93","DOI":"10.5505\/tjtes.2011.69783","volume":"17","author":"NF Ya\u015far","year":"2011","unstructured":"Ya\u015far NF. Pneumomediastinum and subcutaneous emphysema caused by sigmoid diverticulum perforation secondary to blunt abdominal trauma: report of a case. Turk J Trauma Emerg Surg. 2011;17(1):93\u20135.","journal-title":"Turk J Trauma Emerg Surg"},{"issue":"1","key":"4488_CR3","doi-asserted-by":"publisher","first-page":"19","DOI":"10.1007\/s13244-016-0532-3","volume":"8","author":"MR Onur","year":"2017","unstructured":"Onur MR, Akpinar E, Karaosmanoglu AD, Isayev C, Karcaaltincaba M. Diverticulitis: a comprehensive review with usual and unusual complications. Insights Imaging f\u00e9vr. 2017;8(1):19\u201327.","journal-title":"Insights Imaging f\u00e9vr"},{"issue":"2","key":"4488_CR4","doi-asserted-by":"publisher","first-page":"97","DOI":"10.1155\/2007\/943460","volume":"21","author":"E Warner","year":"2007","unstructured":"Warner E, Crighton EJ, Moineddin R, Mamdani M, Upshur R. Fourteen-year study of hospital admissions for diverticular disease in Ontario. Can J Gastroenterol. 2007;21(2):97\u20139.","journal-title":"Can J Gastroenterol"},{"issue":"4","key":"4488_CR5","doi-asserted-by":"publisher","first-page":"542","DOI":"10.1007\/s11605-007-0126-y","volume":"11","author":"L Bordeianou","year":"2007","unstructured":"Bordeianou L, Hodin R. Controversies in the surgical management of sigmoid diverticulitis. J Gastrointest Surg avr. 2007;11(4):542\u20138.","journal-title":"J Gastrointest Surg avr"},{"key":"4488_CR6","doi-asserted-by":"publisher","first-page":"213","DOI":"10.1016\/j.ijscr.2019.02.003","volume":"55","author":"T Muronoi","year":"2019","unstructured":"Muronoi T, Kidani A, Hira E, Takeda K, Kuramoto S, Oka K, et al. Mediastinal, retroperitoneal, and subcutaneous emphysema due to sigmoid colon penetration: a case report and literature review. Int J Surg Case Rep. 2019;55:213\u20137.","journal-title":"Int J Surg Case Rep"},{"issue":"8","key":"4488_CR7","doi-asserted-by":"publisher","first-page":"e241","DOI":"10.1308\/rcsann.2017.0165","volume":"99","author":"G Kourounis","year":"2017","unstructured":"Kourounis G, Lim Q, Rashid T, Gurunathan S. A rare case of simultaneous pneumoperitoneum and pneumomediastinum with a review of the literature. Ann R Coll Surg Engl. 2017;99(8):e241\u20133.","journal-title":"Ann R Coll Surg Engl"},{"key":"4488_CR8","unstructured":"Wang YL, Hsu JY, Fu PK. Pneumomediastinum as a Presentation of Perforated Sigmoid Diverticulitis\u2014A Case Report. 27 (6)."}],"container-title":["Journal of Medical Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13256-024-04488-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s13256-024-04488-1\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13256-024-04488-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,4,17]],"date-time":"2024-04-17T00:01:56Z","timestamp":1713312116000},"score":1,"resource":{"primary":{"URL":"https:\/\/jmedicalcasereports.biomedcentral.com\/articles\/10.1186\/s13256-024-04488-1"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,4,17]]},"references-count":8,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2024,12]]}},"alternative-id":["4488"],"URL":"https:\/\/doi.org\/10.1186\/s13256-024-04488-1","relation":{},"ISSN":["1752-1947"],"issn-type":[{"type":"electronic","value":"1752-1947"}],"subject":[],"published":{"date-parts":[[2024,4,17]]},"assertion":[{"value":"22 January 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"1 March 2024","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"17 April 2024","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable. There is no ethics committee in our hospital and this is a case report where written consent was obtained.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Written informed consent was obtained from the patient for publication of this case report and any accompanying images. A copy of the written consent is available for review by the Editor-in-Chief of this journal.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"187"}}