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All That Is Gas Is Not Gas Gangrene: Mechanical Spread of Gas in the Soft TissuesA Case Report
Vinod K. Panchbhavi, MD, FRCS1; Scott E. Hecox, BS1
1 University of Texas Medical Branch, 301 University Boulevard, Galveston, TX 77555-0165. E-mail address for V.K. Panchbhavi: vkpanchb@utmb.edu
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The authors did not receive grants or outside funding in support of their research for or preparation of this manuscript. They did not receive payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity. No commercial entity paid or directed, or agreed to pay or direct, any benefits to any research fund, foundation, educational institution, or other charitable or nonprofit organization with which the authors are affiliated or associated.
Investigation performed at the University of Texas Medical Branch, Galveston, Texas

The Journal of Bone and Joint Surgery, Incorporated
J Bone Joint Surg Am, 2006 Jun 01;88(6):1345-1348. doi: 10.2106/JBJS.E.01172
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The presence of visible gas on radiographs is associated with various pathological conditions, ranging from severe infections caused by gas-producing organisms to cutaneous and subcutaneous tissue disruption that allows an interface with the air. A high index of suspicion surrounds the finding of gas on radiographs because of the virulence of conditions such as gas gangrene and necrotizing fasciitis.We report a case in which proximal spread of gas in the soft tissues was not due to a spreading infection but rather to a cutaneous ulcer that, during walking activity, possibly acted as a one-way valve, allowing air to dissect proximally. To our knowledge, this mechanism of gas spreading in the soft tissues has not been reported previously. Our patient was informed that information concerning the case would be submitted for publication.
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    gas gangrene ; ulcer

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