Pneumoretroperitoneum following iliac crest trephine

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Abstract
Gas within the retroperitoneum is usually a sign of serious gastrointestinal or urinary tract pathology. Most commonly, it results from bowel perforation secondary to inflammatory or ulcerative disease, blunt or penetrating trauma or to iatrogenic manipulation such as double-contrast barium enema or colonoscopy (Lezak & Goldhammer, 1974; Peterson et al, 1982). Retroperitoneal gas may also result from pancreatitis complicated by bacterial infection or infection in the perirenal space (Meyers, 1974). It has also been reported as a complication of mechanical ventilation when, following alveolar rupture, air tracks into the mediastinum and then passes retrocrurally into the retroperitoneum (Powner et al, 1976). We wish to report a case of pneumoretroperitoneum demonstrated by computed tomography (CT) which we believe to be the first case reported as a complication of iliac crest trephine.