A Case of Mesenteric Penetration of Ascending Colon Cancer with Retroperitoneal Emphysema and Pneumomediastinum

Abstract

The patient was an 85-year-old man who was admitted to our hospital because of right lower abdominal pain. Chest and abdominal CT showed retroperitoneal emphysema, pneumomediastinum and wall thickening at the ascending colon. We performed a right colectomy with lymphadenectomy under a diagnosis of obstructive colon cancer. During the laparotomy, retroperitoneal emphysema and emphysema in the mesentery of the right colon and the gastrocolic ligament were found.

The resected specimen revealed penetration to the mesenteric side at the ulcer floor of a type 2 tumor. The histopathological finding was well differentiated tubular adenocarcinoma, pT3N0M0 Stage IIa. The postoperative course was uneventful and the patient was discharged on the thirteenth postoperative day. Twenty-six cases of colorectal perforation with pneumomediastinum have been reported in Japan. We present our case with a review of the literature.