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Diagnostic and Interventional Imaging Apr 2022
Topics: Catheter Ablation; Cryosurgery; Emphysema; Humans; Kidney; Mediastinal Emphysema; Subcutaneous Emphysema; Tomography, X-Ray Computed
PubMed: 34991992
DOI: 10.1016/j.diii.2021.11.003 -
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 -
La Tunisie Medicale Feb 2023Spontaneous pneumomediastinum (SPM) is a rare affection in general population. Only few cases have been reported during this ongoing global pandemic of Coronavirus-2019...
INTRODUCTION
Spontaneous pneumomediastinum (SPM) is a rare affection in general population. Only few cases have been reported during this ongoing global pandemic of Coronavirus-2019 (COVID-19). The ethipathogeny of this complication is poorly understood.
OBSERVATIONS
we reported ten cases of SPM complicating coronavirus pneumonia. There were six me and four women. Age varies from 32 to 66 years. Pneumonia was severe for all cases defined by a bloo oxygen saturation < 90% on admission. All patients were hospitalized in intensive care unit and treated by high-flow oxygen for nine patients and non-rebreather masks for one patient. Repeated chest computed tomography (CT) scan showed resolution of the pneumomediastinum and appearance of signs of pulmonary fibrosis for four cases.
CONCLUSIONS
Chest CT scan must be performed in front of any sudden deterioration in respiratory status of patients with COVID-19 pneumonia to not miss mechanical complication such as SPM. This complication seems to be associated with severe forms of COVID-19.
Topics: Humans; Female; Adult; Middle Aged; Aged; Mediastinal Emphysema; COVID-19; Pneumonia; Oxygen; Hospitalization
PubMed: 37682278
DOI: No ID Found -
Acta Bio-medica : Atenei Parmensis Sep 2022A 62-year-old man with COVID-19 had PS for fever, coughing, and breathlessness. Two days after therapy, the patient's clinical condition worsened. X-ray and CT showed...
A 62-year-old man with COVID-19 had PS for fever, coughing, and breathlessness. Two days after therapy, the patient's clinical condition worsened. X-ray and CT showed pneumomediastinum, emphysema and pneumothorax. The patient was intubated and subjected to conservative therapy. The patient was discharged after about 20 days. Radiological imaging plays a key role in the proper diagnosis and treatment of COVID-19 patients with related complications.
Topics: COVID-19; Humans; Male; Mediastinal Emphysema; Middle Aged; Pneumothorax; Tomography, X-Ray Computed
PubMed: 36134719
DOI: 10.23750/abm.v93iS1.13061 -
Dental and Medical Problems 2019Subcutaneous emphysema (SE) is a rare but potentially life-threatening complication in dental procedures. The development of SE and pneumomediastinum (P) during tooth...
Subcutaneous emphysema (SE) is a rare but potentially life-threatening complication in dental procedures. The development of SE and pneumomediastinum (P) during tooth extraction is an uncommon complication. The roots of the second and third lower molars (and, rarely, of the premolar and first molar) communicate directly with the sublingual and submandibular spaces. Occasionally, after a dental operation, the pressurized air from the drill is forcefully injected into the surrounding subcutaneous tissues proximal to the extraction site in the facial planes. The air might pass through the sublingual and submandibular spaces to the pterygomandibular, parapharyngeal and retropharyngeal spaces, and to the mediastinum. Molar extraction is a common procedure in dental surgery. We report a rare case of extensive cervicofacial SE as well as P, following mandibular second molar extraction with the use of a high-speed dental handpiece, which is specifically designed for restorative treatment. Careful observations of the symptoms and clinical course, and an early initiation of pharmacologic therapy are recommended.
Topics: Humans; Mediastinal Emphysema; Molar; Molar, Third; Subcutaneous Emphysema; Tooth Extraction
PubMed: 31274258
DOI: 10.17219/dmp/108615 -
Oral and Maxillofacial Surgery Sep 2023This case report presents an iatrogenic induced mediastinal emphysema after restorative treatment of the lower left second molar, aimed to highlight the potential...
This case report presents an iatrogenic induced mediastinal emphysema after restorative treatment of the lower left second molar, aimed to highlight the potential life-threatening consequences, and providing diagnostics and treatment concepts of complicated dental induced emphysema based on literature review. A 74-year-old female patient was admitted to the emergency department due to a fall on her shoulder. Additional finding was a significant swelling of the face and neck. In the computer tomography of the head, neck, and thorax, a humerus fracture and pronounced soft tissue emphysema from the infraorbital region to the mediastinum was detected. The patient reported that she had been treated by her dentist 4 days earlier. The treatment had to be discontinued after beginning of a pronounced swelling. Other reasons for the emphysema could be excluded out on an interdisciplinary teamwork. The patient was monitored as an inpatient for 5 days and received intravenous antibiotic therapy. This case report shows the rare complication of pronounced mediastinal emphysema after root canal treatment. Emphysema should always be a differential diagnosis of soft tissue swelling and, in case of doubt, a general medical presentation should be made.
Topics: Humans; Female; Aged; Mediastinal Emphysema; Face; Molar; Tooth Extraction; Subcutaneous Emphysema
PubMed: 35680758
DOI: 10.1007/s10006-022-01088-5 -
International Journal of... 2022Spontaneous hydropneumothorax (HP) and mediastinal emphysema (ME) are infrequently presented complications of pulmonary tuberculosis (TB). A-34-year-old Pakistani male...
Spontaneous hydropneumothorax (HP) and mediastinal emphysema (ME) are infrequently presented complications of pulmonary tuberculosis (TB). A-34-year-old Pakistani male presented with dyspnea, productive cough, and right-sided pleuritic chest pain. He had no history of any surgery, TB, comorbid disease, or other serious pulmonary diseases. Chest radiography revealed a right-sided HP and parenchymal infiltration. The laboratory results of pleural effusion showed elevated adenosine deaminase levels with the empyema features. Acid-fast bacilli were detected and Mycobacterium tuberculosis without any drug resistance grew in the culture both in the sputum and pleural fluid. A chest tube was inserted immediately. A prolonged airway leak was detected. Hepatotoxicity protocol has been initialized (due to increased hepatic enzymes in the initial presentation) and followed without observing any complications associated with the treatment. On the 25 day of the standard TB treatment protocol, we observed hepatic enzymes in the normal range. Around 40-days of a hospitalization period, he started developing fever and methicillin-resistant Staphylococcus aureus was detected in the pleural fluid culture. We introduced linezolid to the treatment regimen in addition to the antituberculosis protocol. Although spontaneous ME is a benign disease, it might be life-threatening and difficult to manage when complicated with HP and active TB infection. Active TB should be considered a differential diagnosis once ME or HP was detected, and treatment should be started immediately for both diseases.
Topics: Adult; Hospitalization; Humans; Hydropneumothorax; Male; Mediastinal Emphysema; Methicillin-Resistant Staphylococcus aureus; Tuberculosis, Pulmonary
PubMed: 35775553
DOI: 10.4103/ijmy.ijmy_130_20 -
WMJ : Official Publication of the State... Dec 2023Coronavirus disease 2019 (COVID-19) can cause multisystem complications, with pulmonary involvement associated with the highest mortality. Pneumothorax (PT) and...
INTRODUCTION
Coronavirus disease 2019 (COVID-19) can cause multisystem complications, with pulmonary involvement associated with the highest mortality. Pneumothorax (PT) and pneumomediastinum (PM) are uncommon complications of COVID-19 that have been reported to occur in the absence of trauma or mechanical ventilation. This study seeks to determine the incidence of these complications in patients with COVID-19 and evaluate clinical characteristics and outcomes.
METHODS
We identified 3375 patients admitted to our health system during March 2020 through November 2020 who tested positive for SARS-CoV-2 with a polymerase chain reaction test. Patients were screened for PT or PM and were matched to COVID-19-positive patients without PT and/or PM. Data compared demographics, clinical characteristics, and laboratory values.
RESULTS
Out of a total of 3375 COVID-19 admissions, 33 patients with PT/PM (1%) were compared to 32 matched controls without PT and/or PM. The patients with PT and/or PM demonstrated a significantly higher incidence of concomitant cancer diagnosis than those without PT and/or PM (18% vs 3%, respectively; = 0.05). Those with PT and/or PM required significantly more invasive mechanical ventilation than those without PT and/or PM (79% vs 47%; < 0.01). Mortality was significantly higher among those patients with PT and/or PM than those without PT/PM (55% vs 25%; < 0.05).
DISCUSSION
A significant number of COVID-19 patients with PT and/or PM had a concomitant cancer diagnosis, required supplemental oxygen on admission, and invasive mechanical ventilation during hospitalization. Additionally, the COVID patients with PT and/or PM had significantly higher mortality compared to those without PT and/or PM. However, with all retrospective studies, there are limitations.
Topics: Humans; COVID-19; Incidence; Mediastinal Emphysema; Pneumothorax; Retrospective Studies; SARS-CoV-2; Pneumonia; Prognosis; Neoplasms
PubMed: 38180920
DOI: No ID Found -
BMC Gastroenterology Dec 2022Esophageal perforation (EP) has a high mortality rate and poor prognosis. This single-center retrospective study aims to analyze the related risk factors for benign EP.
BACKGROUND
Esophageal perforation (EP) has a high mortality rate and poor prognosis. This single-center retrospective study aims to analyze the related risk factors for benign EP.
METHODS
We retrospectively analyzed 135 patients with benign EP admitted to the First Affiliated Hospital of Nanchang University from January 2012 to December 2020. Univariate and multivariate logistic analysis were performed to estimate risk factors for prognosis of esophageal perforation patients.
RESULTS
There were 118 EP patients with foreign body ingestion and 17 patients with nonforeign body ingestion. Fish bones (78/118) were the most common foreign body and most of the nonforeign EPs were caused by spontaneous esophageal rupture (14/17). Foreign body perforations occurred mostly in the upper thoracic segment (70/118) and middle thoracic segment (31/118), and spontaneous esophageal ruptures occurred mostly in the lower thoracic segment (15/17). Fifteen patients (11.1%) died during hospitalization or within one month of discharge. Multivariable logistic regression analysis showed that high white blood cell (WBC) levels [odds ratio (OR) = 2.229, 95% confidential interval (CI): 0.776-6.403, P = 0.025], chest or mediastinal emphysema (OR = 7.609, 95% CI: 2.418-23.946, P = 0.001), and time to treatment > 72 h (OR = 3.407, 95% CI: 0.674-17.233, P = 0.018) were independent risk factors for poor prognosis.
CONCLUSION
Foreign body was the major reason for benign EP. High WBC level, chest or mediastinal emphysema and time to treatment > 72 h were risk factors for poor prognosis.
Topics: Animals; Esophageal Perforation; Retrospective Studies; Mediastinal Emphysema; Prognosis; Foreign Bodies; Risk Factors
PubMed: 36550403
DOI: 10.1186/s12876-022-02624-z -
Journal of Radiology Case Reports Oct 2022Spontaneous pneumomediastinum is characterized by the accumulation of air in the mediastinum with no identified cause. It is a rare and self-limiting condition. We...
Spontaneous pneumomediastinum is characterized by the accumulation of air in the mediastinum with no identified cause. It is a rare and self-limiting condition. We report the case of a 32-year-old female patient with controlled bronchial asthma, who presented with spontaneous pneumomediastinum, with no precipitating event. The evolution is generally benign and the treatment is conservative. Symptomatic medication may be instituted.
Topics: Young Adult; Female; Humans; Adult; Mediastinal Emphysema; Tomography, X-Ray Computed
PubMed: 36353291
DOI: 10.3941/jrcr.v16i10.4565