{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,12]],"date-time":"2025-10-12T01:56:16Z","timestamp":1760234176841,"version":"build-2065373602"},"reference-count":6,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2021,4,15]],"date-time":"2021-04-15T00:00:00Z","timestamp":1618444800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Simultaneous occurrence of pneumoperitoneum, pneumoretroperitoneum, pneumomediastinum and subcutaneous emphysema is rare. The most reported mechanisms are barotrauma, thermal injury and instrument puncture caused by colonoscopy. Ectopic air may travel into different body compartments through distinct anatomical fascial planes. Definite curative treatment involves surgical repair of the bowel wall defect. Conservative treatment is available in selected patients. Here, we present a case of traumatic penetrating rectal injury leading to developing air in the peritoneum, retroperitoneum, mediastinum, and subcutaneous space with good recovery under conservative treatment.<\/jats:p>","DOI":"10.3390\/diagnostics11040707","type":"journal-article","created":{"date-parts":[[2021,4,15]],"date-time":"2021-04-15T12:11:00Z","timestamp":1618488660000},"page":"707","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Pneumomediastinum, Pneumoretroperitoneum, Pneumoperitoneum and Subcutaneous Emphysema Secondary to a Penetrating Anal Injury"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5633-4478","authenticated-orcid":false,"given":"Yu-Ting","family":"Hsiao","sequence":"first","affiliation":[{"name":"Department of Emergency Medicine, Ditmanson Medical Foundation Chiayi Christian Hospital, Chiayi 600, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shyh-Wen","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Ditmanson Medical Foundation Chiayi Christian Hospital, Chiayi 600, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pei Wen","family":"Chuang","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Ditmanson Medical Foundation Chiayi Christian Hospital, Chiayi 600, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2662-1206","authenticated-orcid":false,"given":"Ming-Jen","family":"Tsai","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Ditmanson Medical Foundation Chiayi Christian Hospital, Chiayi 600, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2021,4,15]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"e7","DOI":"10.1055\/s-0038-1624563","article-title":"Anatomical and Radiological Considerations When Colonic Perforation Leads to Subcutaneous Emphysema, Pneumothoraces, Pneumomediastinum, and Mediastinal Shift","volume":"4","author":"Abdalla","year":"2018","journal-title":"Surg. J."},{"key":"ref_2","first-page":"269","article-title":"Rectosigmoidoscopy complicated by bilateral pneumothoraces, pneumomediastinum, pneumoperitoneum, pneumoretroperitoneum, and pneumoderma","volume":"23","author":"Turna","year":"2017","journal-title":"Ulus. Travma. Acil. Cerrahi. Derg."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"S103","DOI":"10.4097\/kjae.2013.65.6S.S103","article-title":"Subcutaneous emphysema, pneumomediastinum, pneumoretroperitoneum, and pneumoperitoneum secondary to colonic perforation during colonoscopy","volume":"65","author":"Kim","year":"2013","journal-title":"Korean J. Anesthesiol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"e241","DOI":"10.1308\/rcsann.2017.0165","article-title":"A rare case of simultaneous pneumoperitoneum and pneumomediastinum with a review of the literature","volume":"99","author":"Kourounis","year":"2017","journal-title":"Ann. R. Coll. Surg. Engl."},{"key":"ref_5","first-page":"1","article-title":"Pneumoperitoneum, Retropneumoperitoneum, Pneumomediastinum, and Diffuse Subcutaneous Emphysema following Diagnostic Colonoscopy","volume":"2012","author":"Falidas","year":"2012","journal-title":"Case Rep. Surg."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"256","DOI":"10.1159\/000475750","article-title":"Recognition of Extraperitoneal Colonic Perforation following Colon-oscopy: A Review of the Literature","volume":"11","author":"Tiwari","year":"2017","journal-title":"Case Rep. Gastroenterol."}],"container-title":["Diagnostics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4418\/11\/4\/707\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T05:48:15Z","timestamp":1760161695000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4418\/11\/4\/707"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,4,15]]},"references-count":6,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2021,4]]}},"alternative-id":["diagnostics11040707"],"URL":"https:\/\/doi.org\/10.3390\/diagnostics11040707","relation":{},"ISSN":["2075-4418"],"issn-type":[{"type":"electronic","value":"2075-4418"}],"subject":[],"published":{"date-parts":[[2021,4,15]]}}}