Subcutaneous cervical emphysema and pneumomediastinum due to a diastatic rupture of the cecum

Pneumomediastinum usually occurs after esophageal or chest trauma. Subcutaneous cervical emphysema as a presentation of non-traumatic colonic perforation following colorectal cancer or diverticulitis, is very rare.We report a case of a patient with rectal cancer who developed a diastatic cecum retroperitoneal perforation with a secondary pneumo-mediastinum and cervical emphysema. The patient was in treatment with a neoadjuvant chemo-radiotherapy for a low rectal cancer.Treatment consisted in an emergency right hemi-colectomy with ileostomy and performance of distal colonic fistula.The Authors discuss the occurrence of pneumomediastinum and cervical emphysema complicating rectal cancer, pointing out ethio-pathogenesis, clinical presentation, diagnosis and treatment. The importance of performing a diverting colostomy when neoadjuvant chemotherapy is scheduled in patients with stenotic rectal cancer, although not clinically occluded