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©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Dec 6, 2025; 13(34): 112593
Published online Dec 6, 2025. doi: 10.12998/wjcc.v13.i34.112593
Published online Dec 6, 2025. doi: 10.12998/wjcc.v13.i34.112593
Perforated sigmoid colon diverticulitis initially presenting with pneumoperitoneum, pneumoretroperitoneum, and pneumomediastinum: A case report
Po-En Wu, Po-Jung Chen, Wei-Chih Su, Tsung-Kun Chang, Yen-Cheng Chen, Division of Colorectal Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
Po-Jung Chen, Wei-Chih Su, Tsung-Kun Chang, Yen-Cheng Chen, Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
Wei-Chih Su, Tsung-Kun Chang, Department of Surgery, Faculty of Post-Baccalaureate Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
Yen-Cheng Chen, Department of Surgery, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
Author contributions: Wu PE and Chen YC contributed to manuscript writing and editing, and data collection; Chen PJ, Su WC, and Chang YK contributed to conceptualization. All authors have read and approved the final manuscript.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yen-Cheng Chen, MD, Assistant Professor, Division of Colorectal Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, No. 100 Tzyou 1st Road, Kaohsiung 80708, Taiwan. googoogi05@gmail.com
Received: August 4, 2025
Revised: August 27, 2025
Accepted: November 14, 2025
Published online: December 6, 2025
Processing time: 124 Days and 18.7 Hours
Revised: August 27, 2025
Accepted: November 14, 2025
Published online: December 6, 2025
Processing time: 124 Days and 18.7 Hours
Core Tip
Core Tip: This case highlights the rare but critical complications of pneumoretroperitoneum and pneumomediastinum in perforated diverticulitis, emphasizing the importance of high clinical suspicion in patients with atypical presentations. Timely computed tomography imaging and prompt surgical intervention are essential, as delayed diagnosis can lead to increased morbidity and mortality. Despite the absence of typical peritoneal signs, early detection and intervention are crucial for improving patient outcomes.