Saudi Journal of Gastroenterology
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IMAGE QUIZ  
Year : 2013  |  Volume : 19  |  Issue : 3  |  Page : 136-137
Acute abdomen associated with retroperitoneal gas


1 Department of Surgery, Lady Hardinge Medical College, Delhi, India
2 Department of Surgery, Dr. RML Hospital, Delhi, India

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Date of Web Publication16-May-2013
 

How to cite this article:
Gupta N, Kala S, Sharma D. Acute abdomen associated with retroperitoneal gas. Saudi J Gastroenterol 2013;19:136-7

How to cite this URL:
Gupta N, Kala S, Sharma D. Acute abdomen associated with retroperitoneal gas. Saudi J Gastroenterol [serial online] 2013 [cited 2019 Nov 19];19:136-7. Available from: http://www.saudijgastro.com/text.asp?2013/19/3/136/111957


A 50-year old male presented to the emergency department with abdominal pain for 3 days associated with non- bilious vomiting and constipation. There was a history of high-grade fever for 1 day. There was a history of such episodes in the past. He was a chronic smoker and alcoholic. On examination, his pulse rate was found to be 110/min, blood pressure (BP) was 90/70 mmHg and there was no icterus. There was diffuse tenderness and guarding all over the abdomen, and bowel sounds were absent. His laboratory investigations revealed hemoglobin (Hb) 8g%, total leukocyte count 18,000/mm 3 , bilirubin 1.1mg%, urea 18mg%, and amylase 1218 IU. Abdominal X-ray did not reveal any pneumoperitoneum. Abdominal sonography showed dilated bowel loops with minimal inter-loop fluid, normally distended gall bladder, and obscured retroperitoneum. Contrast-enhanced computerized tomographic (CT) scan of the abdomen was carried out, which showed a bulky pancreas with non-enhancing areas in the body and tail. Extensive gas, and a few collections were seen in the peripancreatic region [Figure 1].
Figure 1: CT image showing retroperitoneal gas

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   Questions Top


Q1. What is the diagnosis?
Q2. How would you manage this condition?



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   References Top

1.Wig JD, Kochhar R, Bharathy KG, Kudari AK, Doley RP, Yadav TD, et al. Emphysematous pancreatitis. Radiological curiosity or a cause for concern? JOP 2008;9:160-6.  Back to cited text no. 1
    
2.Ghidirim G, Gagauz I, Miºin I, Guþu E, Vozian M. [Emphysematous necrotizing pancreatitis]. Chirurgia (Bucur) 2005;100:293-6.  Back to cited text no. 2
    
3.Omezzine SJ, Hmida N, Hamza HA. Emphysematous pancreatitis: The utility of CT. Radiography 2009;15:182-4.  Back to cited text no. 3
    

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Correspondence Address:
Nikhil Gupta
B 406 Panchsheel Apartments, Plot 9, Sector 10, Dwarka, Delhi- 110 075
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1319-3767.111957

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