Fig. 15
From: The anatomical compartments and their connections as demonstrated by ectopic air
Air spread from pelvis to inferior limbs. a, b The same patient as in Fig. 2: a 44-year-old man with broncho-pleural fistula secondary to pneumothorax drainage and subsequent rapidly progressive emphysema from neck to groin. a Axial CT in “lung window” shows air spread through the thinned transversalis fascia and abdominal rectus below the level of arcuate line, involving inferior epigastric vessels. Air is seen anteriorly to iliac muscles (brown arrow). b Axial CT caudal to a demonstrates air spreading out the pelvis along with iliac vessels through the femoral canal. Air dissecting along muscular fibres and sheaths, as can be seen from the pelvis along iliac muscle until its insertion in the lesser femoral trochanter (brown line). The least resistance of subcutaneous tissues allow easy spread of subcutaneous emphysema. c, d A 60-year-old patient with colonic perforation at optical colonoscopy. Sagittal (c) and coronal (d) reformatted CT images illustrate air spread along the right inguinal (red star) canal and into the scrotal sac