Images in clinical medicine
A 55-year old Albanian female, under treatment for intestinal
diverticulosis, noted an increase in painful sensations in the lower
abdomen, as well as an unexpected sense of suffocation. She had a
previous colonoscopy two years before re-appearing for consultancy, and
the examination was repeated under anesthesia (midazolam, fentanyl).
20 centimeters from the anal margin a bleeding diverticulum approaching
two centimeters in diameter was noted; some thirty centimeters orad other diverticula with normal mucosal appearance are seen (Figure 1A and
1B).
The patient had the same afternoon a total body CT scan and an abdominal
CT scan with oral contrast enhancement. Air bubbles were visible in both
perirenal areas, advancing to the mediastinum and subcutaneously
laterally, mostly in the left subaxillary and supraclavicular spaces,
and reaching the neck structures (Figure 2A-C).