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European Journal of Case Reports in... 2022Subcutaneous emphysema is the presence of air beneath the skin's soft tissues. It can result from medical conditions, trauma or iatrogenic causes. The occurrence of...
UNLABELLED
Subcutaneous emphysema is the presence of air beneath the skin's soft tissues. It can result from medical conditions, trauma or iatrogenic causes. The occurrence of subcutaneous emphysema after a dental procedure is rare. Although it is mostly a benign and self-limiting complication, the consequences may be severe and life-threatening. We report the case of a 20-year-old man who presented to the emergency department with swelling of his face and neck after dental treatment. The diagnosis of subcutaneous emphysema and pneumomediastinum was made based on physical examination and a computerized tomography scan.
LEARNING POINTS
Subcutaneous emphysema is a rare complication of dental procedures.It is mostly benign and self-limiting, although the consequences may be severe and potentially life-threatening.Early diagnosis and accurate treatment based on understanding its characteristics are important in the prognosis.
PubMed: 35265546
DOI: 10.12890/2022_003153 -
CMAJ : Canadian Medical Association... Sep 2021
Topics: Alcohol Drinking; Esophageal Perforation; Humans; Hydropneumothorax; Male; Mediastinal Diseases; Mediastinal Emphysema; Middle Aged; Vomiting
PubMed: 34580144
DOI: 10.1503/cmaj.202893 -
Pulmonology 2020
Topics: Barotrauma; Cannula; Diving; Humans; Incidence; Male; Mediastinal Emphysema; Mediastinum; Oxygen Inhalation Therapy; Pressure; Radiography, Thoracic; Subcutaneous Emphysema; Treatment Outcome; Young Adult
PubMed: 31735688
DOI: 10.1016/j.pulmoe.2019.09.010 -
Clinical Medicine (London, England) Jul 2020A case is presented highlighting the emerging association of COVID-19 with pneumomediastinum, even in patients who have never received mechanical ventilation or positive...
A case is presented highlighting the emerging association of COVID-19 with pneumomediastinum, even in patients who have never received mechanical ventilation or positive airway pressure.
Topics: Betacoronavirus; COVID-19; Computed Tomography Angiography; Coronavirus Infections; Humans; Male; Mediastinal Emphysema; Middle Aged; Pandemics; Pneumonia, Viral; SARS-CoV-2
PubMed: 32628129
DOI: 10.7861/clinmed.2020-0247 -
Acta Medica (Hradec Kralove) 202074 year-old-man, former smoker, with chronic obstructive pulmonary disease GOLD grade 4, group D, with emphysema component, treated in a pulmonary rehabilitation...
74 year-old-man, former smoker, with chronic obstructive pulmonary disease GOLD grade 4, group D, with emphysema component, treated in a pulmonary rehabilitation program, on oxygen therapy and nocturnal bi-level positive airway pressure (BiPAP) ventilation. During the night he had a traumatic rib fracture (5-11th right ribs) but still he used BiPAP ventilation during the sleep. In the morning after he presented with a diffuse and massive emphysema in the face, thorax and abdominal regions. On physical examination, the patient presented with massive swelling and crepitus on palpation. A chest computed tomography (CT) scan confirmed a diffuse subcutaneous emphysema and revealed a mediastinal emphysema and bilateral small pneumothorax. A fast resolution of the emphysema was of paramount importance as the patient was severely agitated due to his inability to open both eyes, and the need to reintroduce BiPAP ventilation as soon as possible. It was placed a fenestrated subcutaneous catheter on left hemithorax and a subcutaneous ostomy on right hemithorax for comparative purpose. It was also performed a confluent centripetal massage towards drainage orifices, with immediate and substantial improvement of emphysema, especially in left hemithorax, and progressive ocular opening. Further emphysema absorption occurred during hospitalization.
Topics: Aged; Continuous Positive Airway Pressure; Humans; Male; Mediastinal Emphysema; Oxygen Inhalation Therapy; Pulmonary Disease, Chronic Obstructive; Rib Fractures; Subcutaneous Emphysema; Tomography, X-Ray Computed
PubMed: 33355081
DOI: 10.14712/18059694.2020.63 -
Deutsches Arzteblatt International Feb 2022
Topics: Humans; Mediastinal Emphysema; Skin; Subcutaneous Emphysema
PubMed: 35438627
DOI: 10.3238/arztebl.m2022.0016 -
Diagnostic and Interventional Imaging Sep 2022
Topics: Humans; Mediastinal Emphysema; Neck; Subcutaneous Emphysema; Tooth Extraction
PubMed: 35760727
DOI: 10.1016/j.diii.2022.06.005 -
Annals of Thoracic Medicine 2022Coronavirus illness 2019, commonly referred to as COVID-19, is a highly infectious disease brought on by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)....
INTRODUCTION
Coronavirus illness 2019, commonly referred to as COVID-19, is a highly infectious disease brought on by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). COVID-19 was declared a universal pandemic in March 2020 by the World Health Organization and is a severe health issue with unprecedented morbidity and mortality rates. Both surgical and mediastinal emphysema have been seen in cases of critically ill COVID-19 patients in several hospitals in the Eastern Province of Saudi Arabia.
METHODS
This was a retrospective, cross-sectional, multicentric study involving several hospitals in the Saudi Arabian Eastern Province. Data were collected from intensive care units (ICUs) in these hospitals from March 2 to August 2, 2020. The inclusion criteria consisted of all patients who tested positive for SARS-CoV-2 and were admitted to a critical care unit.
RESULTS
Thirty patients required thoracic consultation and management, including 26 males (81.3%) and 4 females (12.5%) (1:0.15) who developed surgical and mediastinal emphysema requiring thoracic surgery intervention. Most of the patients were on high ventilation settings, and the mean duration of ventilator support was 16.50 ± 13.98 days. Two patients (6.3%) required reintubation. The median positive end-expiratory pressure (PEEP) was 12 ± 2.80 cmHO with a median FiO2 of 70% ± 19.73. On average, thoracic complications occurred on day 3 (±6.29 days) postintubation. Ten patients (33.33%) experienced a pneumothorax associated with surgical emphysema (SE), 1 patient (3.33%) presented with only mediastinal emphysema; 17 patients (56.66%) with only SE, and 1 (3.33%) had mediastinal emphysema associated with SE. We noted a correlation between the duration of ventilator support, the length of ICU stay ( < 0.001), and the total length of stay (LOS) in the hospital ( < 0.001). Total length of hospital stay showed significant association with the onset of complications ( = 0.045) and outcomes ( = 0.006). A significant association between PEEP and the duration of ventilator support was also evident with a value = 0.009 and the onset of complications ( = 0.043). In addition, we found a significant association between the group with pneumothorax in combination with SE, and their outcomes, with a = 0.002.
CONCLUSION
Surgical and mediastinal emphysema in the critically ill patients are usually attributed to barotrauma and high ventilations settings. During COVID-19 pandemic, these entities were seen and the pathogenesis was revisited and some attributed its presence to the disease process and destruction on lung parenchyma. The associated with extended LOS and delayed recovery in addition to poor prognosis were seen. Their presence is an indicator to higher morbidity and mortality.
PubMed: 35198049
DOI: 10.4103/atm.atm_600_20 -
Deutsches Arzteblatt International Aug 2023
Topics: Humans; Mediastinal Emphysema
PubMed: 37721139
DOI: 10.3238/arztebl.m2022.0394 -
Veterinary Journal (London, England :... Jun 2024Pneumomediastinum denotes the presence of gas within the mediastinum and generally occurs by leakage of air from an aerated viscus that traverses or abuts the...
Spontaneous pulmonary interstitial emphysema, pneumomediastinum and cervical subcutaneous emphysema secondary to the Macklin effect in dogs with no clinical signs: 12 cases.
Pneumomediastinum denotes the presence of gas within the mediastinum and generally occurs by leakage of air from an aerated viscus that traverses or abuts the mediastinal plane. The Macklin effect has been described in several veterinary studies and describes gas tracking along the perivascular interstitium following alveolar rupture causing interstitial emphysema, pneumomediastinum and subsequently cervical subcutaneous emphysema. This retrospective case series describes incidental spontaneous pulmonary interstitial emphysema, pneumomediastinum and cervical subcutaneous emphysema secondary to the Macklin effect in dogs with no related clinical signs. Twelve dogs were identified from the author's institution, of which 75 % were Sighthounds (Greyhounds, Whippets or Lurchers). Pulmonary interstitial emphysema had a predominantly paravascular distribution, although in some cases a parabronchial distribution was also identified. We conclude that incidental pulmonary interstitial emphysema, pneumomediastinum and secondary cervical subcutaneous emphysema can be incidental, presumed secondary to the Macklin effect and that Sighthound breeds may be overrepresented.
PubMed: 38849024
DOI: 10.1016/j.tvjl.2024.106158