Major causes of pneumoretroperitoneum

What are the major causes of pneumoretroperitoneum?

Pneumoretroperitoneum (i.e., gas in the retroperitoneum) is most often due to bowel perforation involving the retroperitoneal portions of bowel (i.e., the second through fourth portions of the duodenum, ascending colon, and descending colon). It is less commonly due to inferior extension of gas from the thorax, extracorporeal shock-wave lithotripsy, epidural anesthesia, percutaneous biopsy, abscess formation, necrotizing fasciitis, superinfected necrotizing pancreatitis, bowel infarction, and bowel pneumatosis. Very low attenuation and very low signal intensity gas surrounding retroperitoneal structures are seen on CT and MR images, respectively.

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