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The Medical Journal of Australia Nov 2017
Topics: Asthma; Humans; Male; Mediastinal Emphysema; Subcutaneous Emphysema; Young Adult
PubMed: 29129168
DOI: 10.5694/mja17.00140 -
Minerva Surgery Aug 2023Subcutaneous emphysema (SE) represents, after bleeding and infections, a common complication in ENT surgery, given the intimate relationship between upper airways and... (Review)
Review
INTRODUCTION
Subcutaneous emphysema (SE) represents, after bleeding and infections, a common complication in ENT surgery, given the intimate relationship between upper airways and anatomical area pertaining head and neck surgeon. Aim of this review is to analyze its characteristics, method of diagnosis and treatment to provide the specialist a useful tool for its early recognition.
EVIDENCE ACQUISITION
A narrative review was carried out in accordance with the preferred reporting items for systematic reviews and meta-analyses (PRISMA) statement. A total of 164 articles were collected and most of them were case reports.
EVIDENCE SYNTHESIS
Of 273 articles taken into consideration, only 164 met inclusion criteria. Review of all cases of SE in relation to surgical ENT procedures allow to classify each etiology on the surgical procedure that could be complicated with SE: laryngo-tracheal procedures, thyroid surgery, nasal and otological surgery, adenotonsillectomies. Moreover, traumatic orotracheal intubation, as well as alveolar rupture because of positive pressure ventilation or rupture of a preexisting abnormality, must be always taken into account.
CONCLUSIONS
All ENT surgery can be complicated by SE. Diagnosis is simple and usually based only on physical examination, but correct and quick diagnosis is required. Treatment is in most of the time exclusively conservative, but SE could also represent a surgical emergency, given the possible evolution in pneumothorax/pneumomediastinum with serious consequences for patient's health.
Topics: Humans; Subcutaneous Emphysema; Otorhinolaryngologic Surgical Procedures; Mediastinal Emphysema; Trachea; Intubation, Intratracheal
PubMed: 36951677
DOI: 10.23736/S2724-5691.23.09855-6 -
Gastroenterology Nursing : the Official...
Topics: Humans; Cholangiopancreatography, Endoscopic Retrograde; Mediastinal Emphysema; Tomography, X-Ray Computed; Subcutaneous Emphysema
PubMed: 37126089
DOI: 10.1097/SGA.0000000000000719 -
Emergencias : Revista de La Sociedad... Oct 2022
Topics: Humans; Mediastinal Emphysema; Tomography, X-Ray Computed
PubMed: 36217942
DOI: No ID Found -
Veterinary Medicine and Science Mar 2022Lacerations of the axillary region occur frequently in horses. Typical complications caused by entrapment of air in the wound during locomotion are subcutaneous...
Lacerations of the axillary region occur frequently in horses. Typical complications caused by entrapment of air in the wound during locomotion are subcutaneous emphysema, with consecutive pneumomediastinum and pneumothorax. In this case report, the clinical, radiographic and laboratory diagnosis and management of these complications after an axillary laceration that finally resulted in pneumoperitoneum are described. A 1-year-old Hannoveranian was presented with a pre-existing axillary laceration of unknown duration and subcutaneous emphysema in the surrounding tissue. Due to extensive tissue loss, attempts to adequately close the wound surgically and by packing with sterile dressing material were unsuccessful. Despite stall confinement and tying of the horse, subcutaneous emphysema was progressive and pneumomediastinum as well as pneumothorax was developed. These complications were monitored radiographically. On day 5 after admission, signs of air accumulation were detected on radiographs craniodorsally in the peritoneum and a pneumoperitoneum was diagnosed. Repeated thoracentesis with a teat cannula to gradually evacuate the thoracic cavity was used in combination with nasal oxygen insufflation to treat global respiratory insufficiency. Subcutaneous emphysema and all other complications resolved progressively and the horse was discharged from the hospital 21 days after admission when the axillary wound was adequately filled with granulation tissue. The wound healed fully 1 month later and the horse did not develop long-term complications within the following year. To the authors´ knowledge, the development of pneumoperitoneum including its radiographic monitoring following an axillary laceration has not been described in horses previously.
Topics: Animals; Horse Diseases; Horses; Insufflation; Lacerations; Mediastinal Emphysema; Pneumoperitoneum; Pneumothorax; Subcutaneous Emphysema
PubMed: 34990086
DOI: 10.1002/vms3.718 -
BMJ Case Reports Jan 2016
Topics: Adult; Chest Pain; Humans; Male; Mediastinal Emphysema; Neck Pain; Rare Diseases; Tomography, X-Ray Computed; Ultrasonography
PubMed: 26786530
DOI: 10.1136/bcr-2015-213550 -
Journal of Otolaryngology - Head & Neck... Aug 2020Subcutaneous cervical emphysema is a clinical sign associated with many conditions, including laryngotracheal trauma, pneumothorax and necrotizing deep tissue infections. (Review)
Review
BACKGROUND
Subcutaneous cervical emphysema is a clinical sign associated with many conditions, including laryngotracheal trauma, pneumothorax and necrotizing deep tissue infections.
CASE PRESENTATION
We discuss a case of a 76-year-old man presenting with extensive cervical emphysema a few hours after a minor dental filling procedure. The CT-scan revealed a significant amount of air within the cervical and mediastinal spaces, reaching lobar bronchi. Vitals were within normal values Bloodwork demonstrated an elevation of creatinine kinase (3718; normal < 150) and mild leukocytosis (WBC = 11.6). We decided to proceed to an urgent cervical exploration to exclude necrotizing fasciitis. This revealed air but no tissue necrosis nor abnormal fluid. The patient improved clinically and was discharged two days later with oral antibiotics. Although cervicofacial subcutaneous emphysema following dental procedures has been reported, it is usually less extensive and involving more invasive procedures using air-driven handpieces.
CONCLUSION
As an otolaryngologist confronted with extensive subcutaneous emphysema following a potential entry route for an aggressive infection, given the seriousness of this diagnosis, the decision of whether or not to perform a diagnostic surgical exploration should remain.
Topics: Aged; Dental Care; Dental Instruments; Dental Restoration, Permanent; Diagnosis, Differential; Fasciitis, Necrotizing; Humans; Male; Mediastinal Emphysema; Subcutaneous Emphysema; Tomography, X-Ray Computed
PubMed: 32811562
DOI: 10.1186/s40463-020-00455-0 -
European Archives of... Jan 2018Balloon Eustachian tuboplasty (BET) is a new treatment modality addressing chronic obstructive dysfunction of the Eustachian tube (ET). So far, BET has been deemed a...
PURPOSE
Balloon Eustachian tuboplasty (BET) is a new treatment modality addressing chronic obstructive dysfunction of the Eustachian tube (ET). So far, BET has been deemed a safe procedure under general anesthesia with only minor adverse effects. However, individual cases of postoperative emphysema have been reported. In the present retrospective multicenter analysis we determined the incidence rate of this potentially life threatening complication after BET.
METHODS
In total we collected data from 3,670 BET procedures performed on 2,272 patients in four tertiary care ENT departments.
RESULTS
Ten cases of postoperative cervicofacial emphysema were documented, whereas only in 3 of them a pneumomediastinum was developed. None of the affected patients developed at any time serious clinical signs or symptoms besides cutaneous crepitations. A complete resolution and recovery of the emphysema occurred in all patients under antibiotic prophylaxis and abstinence from Valsalva maneuver within the first 2-6 postoperative days.
CONCLUSIONS
Possible causes for the development of these postinterventional emphysemas are considered to be mucosal injuries of the ET during manipulations for the correct position of the insertion instrument, through a "kinking" of the balloon catheter or even due to the relative rigid catheter itself, although its form is regarded to be atraumatic. The complication rate of postoperative emphysema was 0.27% (95% CI 0.13-0.50%). The above facts in addition to only minor and transient overall complications after BET reported in literature, can label this procedure as a safe treatment with a low risk profile.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Child; Emphysema; Eustachian Tube; Face; Female; Humans; Incidence; Male; Mediastinal Emphysema; Middle Aged; Neck; Otologic Surgical Procedures; Postoperative Complications; Retrospective Studies; Young Adult
PubMed: 29143098
DOI: 10.1007/s00405-017-4805-3 -
Medicina Clinica Apr 2022
Topics: COVID-19; Humans; Mediastinal Emphysema; Subcutaneous Emphysema
PubMed: 35115171
DOI: 10.1016/j.medcli.2021.11.006 -
Undersea & Hyperbaric Medicine :... 2022Subcutaneous and mediastinal emphysema are known complications of liposuction and body sculpting procedures. Treatment options are limited, and recovery is often... (Review)
Review
Subcutaneous and mediastinal emphysema are known complications of liposuction and body sculpting procedures. Treatment options are limited, and recovery is often prolonged. We discuss a case of severe subcutaneous and mediastinal emphysema after a skin-tightening procedure involving helium gas. The patient received one treatment of hyperbaric oxygen and was followed until symptom resolution. We review the known literature on hyperbaric oxygen therapy as a treatment for subcutaneous emphysema.
Topics: Helium; Humans; Hyperbaric Oxygenation; Mediastinal Emphysema; Subcutaneous Emphysema
PubMed: 35226978
DOI: No ID Found