case_images: PMC11219207_01
case_images: (a) Colonoscopy revealing a single pedunculated polyp, 10 mm in size, with an irregular and multilobulated shape, and heterogeneous color. (b) A hot snare polypectomy was performed without any incidents or complications.
case_images: CRIGM2024-1140099.001.jpg
case_images: PMC11219207_01_CRIGM2024-1140099.001.jpg
case_images: fig1
case_images: A hot snare polypectomy was performed (Figures 1(a) and 1(b)).
case_images: Classification of the severity of subcutaneous emphysema.
case_images: CRIGM2024-1140099.002.jpg
case_images: PMC11219207_01_CRIGM2024-1140099.002.jpg
case_images: fig2
case_images: On physical examination, subcutaneous emphysema was found from the facial region to the thoracic region Grade V of Aghajanzadeh (Figure 2), with abdominal distention, aperistalsis, and nonspecific generalized abdominal pain, with signs of peritoneal irritation (Figure 3).
case_images: Subcutaneous emphysema in the thoracic, cervical, and facial regions.
case_images: CRIGM2024-1140099.003.jpg
case_images: PMC11219207_01_CRIGM2024-1140099.003.jpg
case_images: fig3
case_images: On physical examination, subcutaneous emphysema was found from the facial region to the thoracic region Grade V of Aghajanzadeh (Figure 2), with abdominal distention, aperistalsis, and nonspecific generalized abdominal pain, with signs of peritoneal irritation (Figure 3).
case_images: Topogram showing pneumoperitoneum, pneumoretroperitoneum, pneumomediastinum, pneumothorax, and massive subcutaneous emphysema.
case_images: CRIGM2024-1140099.004.jpg
case_images: PMC11219207_01_CRIGM2024-1140099.004.jpg
case_images: fig4
case_images: (a) Neck with multiple hypodense gas density areas located in soft tissues and muscular planes, from the base of the skull to the thorax. (b) Soft tissues with multiple gas density areas located towards the anterior thorax and in axillary regions and descending, gas density areas in the right renal fossa, as well as in the bilateral inguinal canal. (c) Mediastinum with the presence of multiple gas density areas of diffuse distribution is observed, with widening of the mediastinum, in the pleural space, in the right and left hemithorax with occupation by gas density images. (d) Sigmoid and rectum wall is observed with an increase in its diameter, with pneumatosis intestinalis, and with loss of interface in the wall of the distal segment of the sigmoid. Multiple areas of gas density, which are distributed throughout the retroperitoneum and peritoneum, and ascend to the diaphragmatic hiatus.
case_images: CRIGM2024-1140099.005.jpg
case_images: PMC11219207_01_CRIGM2024-1140099.005.jpg
case_images: fig5
case_images: Perforation of 2 cm of diameter in the sigmoid in its distal segment on the right posterolateral wall.
case_images: CRIGM2024-1140099.006.jpg
case_images: PMC11219207_01_CRIGM2024-1140099.006.jpg
case_images: fig6
case_images: Simple chest X-ray showing adequate resolution of pneumothorax, pneumomediastinum, and decrease of the subcutaneous emphysema.
case_images: CRIGM2024-1140099.007.jpg
case_images: PMC11219207_01_CRIGM2024-1140099.007.jpg
case_images: fig7
case_images: On the fourth day, a simple chest X-ray with a posteroanterior projection control was performed, finding adequate resolution of the pneumothorax and pneumomediastinum, even visualizing radiolucent areas in soft tissues suggestive of subcutaneous emphysema, and removal of the endopleural tubes was performed, without any eventualities (Figure 7).