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European Journal of Internal Medicine Nov 2014
Topics: Adolescent; Humans; Male; Mediastinal Emphysema; Prognosis; Tomography, X-Ray Computed
PubMed: 25023922
DOI: 10.1016/j.ejim.2014.06.010 -
The American Journal of Case Reports Jun 2023BACKGROUND The nasogastric tube (NGT) is a common medical device, and serious complications associated with NGT insertions are rare. The most common serious complication...
BACKGROUND The nasogastric tube (NGT) is a common medical device, and serious complications associated with NGT insertions are rare. The most common serious complication is tracheal insertion; cervical emphysema and pneumomediastinum are rare. There are several methods for confirming the location of the NGT, but a single method of confirmation is often inadequate. Confirmation by air insufflation into the NGT is currently not recommended and is highly invasive. Here, we report a case of cervical emphysema and pneumomediastinum caused by an NGT. CASE REPORT A 94-year-old woman experienced a stroke and was hospitalized for neurosurgery. The nurse inserted an NGT and performed insufflation, but air sounds were not detected. Chest radiography did not reveal the tip of the NGT. Computed tomography (CT) revealed cervical emphysema, pneumomediastinum, an NGT bent in the esophagus, and the distal end of the NGT in the nasopharynx. Nasopharyngeal endoscopy revealed damaged nasopharyngeal mucosa and the distal end of the NGT. The patient was diagnosed with insufflated air passing through the damaged nasopharynx, which had spread to the cervical area and mediastinum. The NGT was removed, and the patient was treated with antibiotics. CT showed cervical emphysema, and the pneumomediastinum resolved after 20 days. CONCLUSIONS It is important to recognize that there are numerous serious and unexpected complications associated with NGT. Different methods should be considered and used to confirm the location of an NGT. Further studies on the confirmation methods and dissemination of such knowledge are required to reduce NGT complications.
Topics: Female; Humans; Aged, 80 and over; Mediastinal Emphysema; Emphysema; Intubation, Gastrointestinal; Radiography; Tomography, X-Ray Computed; Pulmonary Emphysema
PubMed: 37269087
DOI: 10.12659/AJCR.939836 -
QJM : Monthly Journal of the... Mar 2024
Topics: Humans; Mediastinal Emphysema; Asthma; Subcutaneous Emphysema
PubMed: 37988141
DOI: 10.1093/qjmed/hcad263 -
Ugeskrift For Laeger Sep 2022This is a case report of a young woman with diabetes mellitus type 1. She was admitted with severe diabetic ketoacidosis. Asymptomatic "surgical emphysema",...
This is a case report of a young woman with diabetes mellitus type 1. She was admitted with severe diabetic ketoacidosis. Asymptomatic "surgical emphysema", pneumomediastinum and bilateral pneumothoraces were accidently discovered. The emphysema had probably occurred due to laboured breathing and groaning during her diabetic ketoacidosis. No treatment was needed.
Topics: Chest Pain; Diabetic Ketoacidosis; Female; Humans; Mediastinal Emphysema; Pneumothorax; Pulmonary Emphysema; Respiration; Subcutaneous Emphysema
PubMed: 36178181
DOI: No ID Found -
Lung Oct 2014
Topics: Humans; Hypoxia; Infant, Newborn; Male; Mediastinal Emphysema; Oxygen Inhalation Therapy; Radiography; Respiratory Distress Syndrome, Newborn; Treatment Outcome
PubMed: 24903025
DOI: 10.1007/s00408-014-9601-x -
Folia Medica Sep 2019Asthma is the most common chronic respiratory disease worldwide and its prevalence is increasing. Acute asthma complications are often the reason for admission to... (Review)
Review
Asthma is the most common chronic respiratory disease worldwide and its prevalence is increasing. Acute asthma complications are often the reason for admission to emergency healthcare service. In our article we present a case of a rare asthma complication – spontaneous pneumomediastinum with a short review of its incidence, etiology, diagnosis and management. Spontaneus pneumothorax is important to differentiate with secondary pneumomediastinum as well as other conditions as cardiac diseases (acute coronary syndrome, pericarditis, cardiac tamponade, pneumopericardium), lung diseases (pneumothorax, pulmonary embolism, tracheobronchial tree rupture), musculoskeletal disorders, and diseases of the esophagus (rupture and perforation o the esophagus). A chest X-ray is often reliable for diagnosis of spontaneous pneumomediastinum and when inconclusive, can be followed by CT. The management is usually conservative with oxygen and analgesia. Surgery is required only in cases of tracheobronchial compression.
Topics: Acute Disease; Asthma; Humans; Male; Mediastinal Emphysema; Young Adult
PubMed: 32337937
DOI: 10.3897/folmed.61.e39419 -
Nederlands Tijdschrift Voor Geneeskunde 2015Pneumomediastinum is characterized by the presence of free air in the mediastinum. This can be a sign of a severe underlying disorder that requires urgent intervention.... (Review)
Review
Pneumomediastinum is characterized by the presence of free air in the mediastinum. This can be a sign of a severe underlying disorder that requires urgent intervention. However, pneumomediastinum is also associated with other causes that can be treated conservatively. Here, we describe three patients who presented with a primary or spontaneous pneumomediastinum and a secondary pneumomediastinum due to traumatic or iatrogenic perforation. Recognition of the underlying cause of pneumomediastinum is essential for further diagnostic studies and patient management. Unnecessary investigations and interventions, which may cause further harm to and hospitalization of the patient, can thereby be prevented.
Topics: Adult; Aged; Diagnosis, Differential; Female; Humans; Male; Mediastinal Emphysema; Physical Examination
PubMed: 26443118
DOI: No ID Found -
Medicina 2023Hamman's syndrome, or spontaneous pneumomediastinum, is the presence of air in the mediastinum without a history of previous pulmonary pathology, chest trauma or...
Hamman's syndrome, or spontaneous pneumomediastinum, is the presence of air in the mediastinum without a history of previous pulmonary pathology, chest trauma or iatrogenesis. It has been described as a rare complication in patients with COVID-19 pneumonia. It is postulated that an increase in airway pressure associated with diffuse alveolar damage caused by the virus produces an air leak into the mediastinum. Chest pain and dyspnea associated with subcutaneous emphysema should make the treating physician suspicious. We introduce a 79-year-old patient who, during hospitalization for pneumonia secondary to COVID-19, suddenly developed dyspnea, chest pain, coughing spells and bronchospasm with the discovery of spontaneous pneumomediastinum on chest tomography. He evolved favorably with bronchodilator treatment and temporary oxygen therapy. Hamman's syndrome is a rare cause of respiratory failure progression in patients with COVID-19 pneumonia. Its recognition is crucial to implement the appropriate treatment.
Topics: Male; Humans; Aged; SARS-CoV-2; Mediastinal Emphysema; COVID-19; Dyspnea; Chest Pain; Syndrome
PubMed: 37379547
DOI: No ID Found -
Internal and Emergency Medicine Sep 2021
Topics: Adolescent; Chest Pain; Humans; Male; Mediastinal Emphysema; Radiography; Thymus Gland
PubMed: 33453009
DOI: 10.1007/s11739-020-02626-3 -
Klinicka Mikrobiologie a Infekcni... Mar 2022Spontaneous pneumothorax, pneumomediastinum and subcutaneous emphysema are serious complications of COVID-19 infection caused by SARS-CoV-2, occurring in approximately...
Spontaneous pneumothorax, pneumomediastinum and subcutaneous emphysema are serious complications of COVID-19 infection caused by SARS-CoV-2, occurring in approximately 1% of hospitalized patients. The risk increases with the accumulation of risk factors, namely moderate or severe illness, high-flow oxygen therapy and noninvasive ventilation. The pathophysiology may be contributed to by patient self-inflicted lung injury. Hypoxia-induced respiratory effort in patients with pneumonia puts an enormous load on certain parts of their lungs, leading to subsequent progression of lung tissue damage. These complications start with destruction of the alveolar membrane, accompanied by emergence of a pulmonary bulla. Rupture of the bulla results in air leaking to the pleural space (pneumothorax). In the case of pneumomediastinum, the air spreads within the peribronchial interstitium along the airways to the mediastinum and subcutaneous tissues (Macklin effect). While pneumomediastinum and subcutaneous emphysema resolve spontaneously in most cases, pneumothorax treatment depends on its magnitude. While small pneumothorax may be managed conservatively, large pneumothorax usually requires active treatment with an acute chest drain; the latter is also associated with worse prognosis and a higher chance of death. We report air-leak complications in nine COVID-19 patients, of whom seven had spontaneous pneumothorax and four of them died. Three patients developed spontaneous pneumomediastinum together with subcutaneous emphysema, with two of them surviving. One patient with combination of pneumothorax, pneumomediastinum and subcutaneous emphysema died. These complications may accompany moderate or severe COVID-19-associated pneumonia, mostly the late phase of the disease. They should be considered when patients complain of sudden chest or back pain or worsening respiratory insufficiency.
Topics: Blister; COVID-19; Humans; Mediastinal Emphysema; Oxygen; Pneumothorax; SARS-CoV-2; Subcutaneous Emphysema
PubMed: 36183411
DOI: No ID Found