Bowel Perforation Presenting as Head and Neck Subcutaneous Emphysema

This patient with Crohn's disease underwent endoscopic balloon dilatation of an ileocolic stricture, and shortly thereafter developed subcutaneous emphysema in the soft tissues of her face, neck, and chest wall. Clinical evaluation and imaging revealed peritonitis from perforated bowel. She underwent laparotomy and bowel resection and recovered well. Subcutaneous emphysema in the head and neck from perforated bowel is a rare but recognized presentation of viscus perforation.