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Peter Alan Kosovsky, MD; Brighita Weinberg, MD; Bernard Lewin, MD; Ulrick Vieux, MD

JAMA. 1986;256(3):383-384.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

History

A 60-year-old woman with a history of alcohol abuse and hypertension presented to the emergency room because of increasing fatigue and shaking chills. Her temperature was 39.7°C (103.4°F) and her blood pressure was 90/60 mm Hg. Tenderness was present in the left upper and lower quadrants of the abdomen with guarding. Crepitus was noted along the left lateral side of the abdominal wall. Laboratory findings included a white blood cell count of 20 000/mm³ (20.0x10⁹/L) with a leftward shift, abnormal results on liver function tests, anemia, a serum urea nitrogen concentration of 44 mg/ dL (15.5 mmol/L), and a creatinine level of 1.6 mg/dL (140 µmol/L), in addition to a prolonged prothrombin time.

Roentgenograms of the abdomen and chest were obtained (Fig 1).

Diagnosis

Pneumoretroperitoneum, pneumomediastinum, and subcutaneous emphysema secondary to sigmoid diverticulitis with extraperitoneal perforation.

A plain x-ray film of the abdomen showed a calcified . . . [Full Text PDF of this Article]

Author Affiliations
From the Department of Radiology, Mount Sinai Hospital and Mount Sinai Services, City Hospital Center at Elmhurst, Elmhurst, NY.

Footnotes
Reprint requests to the Department of Radiology, City Hospital Center at Elmhurst, 79-01 Broadway Avenue, Elmhurst, NY 11373 (Dr Weinberg).

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