Extensive retroperitoneal air, pneumomediastinum, and subcutaneous air secondary to stercoral perforation.

Stercoral perforation is an uncommon cause of large intestinal perforation that is typically the result of chronic constipation. Historically, this disease process has a devastatingly high mortality rate, and recent evidence questions the incidence of the disease, once thought to be scarce. We report the case of an elderly woman presenting with symptoms related to mediastinal and soft tissue air in the neck from dissection of air retroperitoneally from stercoral perforation. She had minimal abdominal complaints and no history of chronic constipation. The emergency provider should be aware that this disease entity exists and should be cognizant that retroperitoneal pathology may present with complaints referable to the chest or even neck with a paucity of abdominal findings.