Subcutaneous emphysema: an indirect sign of anastomotic leak in cecal volvulus

Authors

  • Vee Chuan Hoe Department of Surgery, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
  • Shu Ning Kong Department of Surgery, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
  • Peh Voon Yeow Gilbert Department of Surgery, Queen Elizabeth Hospital, Ministry of Health Malaysia, Kota Kinabalu, Malaysia
  • Muhammad Amirrul Nizam Razi Department of Surgery, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Malaysia
  • Rohamini Sibin Department of Surgery, Queen Elizabeth Hospital, Ministry of Health Malaysia, Kota Kinabalu, Malaysia
  • Firdaus Hayati Department of Surgery, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Malaysia

DOI:

https://doi.org/10.13181/mji.cr.247507

Keywords:

anastomotic leak, cerebral palsy, subcutaneous emphysema, volvulus

Abstract

Cecal volvulus (CV) is a rare cause of intestinal obstruction. A 22-year-old man with cerebral palsy presented with intestinal obstruction symptoms for 2 days. Abdominal computed tomography (CT) revealed a severely dilated cecum, confirmed as CV, during exploratory laparotomy. A right hemicolectomy with primary anastomosis was performed due to an unhealthy cecum. However, his postoperative recovery was stormy as he developed right flank subcutaneous emphysema, but the surgical drain was empty. Follow-up CT showed no extravasation of oral contrast from the lumen, but a relaparotomy noticed a small leak at the posterolateral aspect of the anastomosis, which was reinforced. He recovered well and was discharged 5 days after the relaparotomy. In conclusion, despite being uncommon, subcutaneous emphysema can become an indirect sign of an anastomotic leak even in a negative CT scan.

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References

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Published

2025-03-27

How to Cite

1.
Hoe VC, Kong SN, Gilbert PVY, Razi MAN, Sibin R, Hayati F. Subcutaneous emphysema: an indirect sign of anastomotic leak in cecal volvulus. Med J Indones [Internet]. 2025 Mar. 27 [cited 2025 Apr. 2];34(1):68-70. Available from: https://mji.ui.ac.id/journal/index.php/mji/article/view/7507

Issue

Section

Case Report/Series