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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 -
Pulmonology 2021
Topics: Diving; Humans; Mediastinal Emphysema
PubMed: 32788058
DOI: 10.1016/j.pulmoe.2020.07.004 -
Cureus Jun 2023Subcutaneous emphysema (SE) and pneumomediastinum are rare complications of air beneath the skin layers and in the mediastinal space, respectively, following routine...
Subcutaneous emphysema (SE) and pneumomediastinum are rare complications of air beneath the skin layers and in the mediastinal space, respectively, following routine dental procedures. A few cases exist in the literature. A 53-year-old female presented to the emergency department shortly after a cavity filling, with marked swelling of her right orbit, face, and neck. Physical examination and computed tomography (CT) revealed subcutaneous emphysema and pneumomediastinum. The patient was treated with prophylactic antibiotics for one week and Peridex rinse twice daily. Subcutaneous emphysema and pneumomediastinum cases have been associated with potentially life-threatening sequelae and infections. Although these conditions are almost exclusively benign and self-limiting, physicians should consider the associated fatal complications and manage accordingly. Dental providers should be able to recognize this complication and provide patients with appropriate guidance.
PubMed: 37525788
DOI: 10.7759/cureus.41177 -
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 -
The Lancet. Infectious Diseases Apr 2020
Topics: Adult; COVID-19; China; Coronavirus Infections; Humans; Male; Mediastinal Emphysema; Pandemics; Pneumonia, Viral
PubMed: 32164830
DOI: 10.1016/S1473-3099(20)30156-0 -
Academic Radiology Nov 2021Spontaneous pneumomediastinum (SPM) is a rare condition defined by the presence of air in the mediastinum in the absence of traumatic or iatrogenic injury. Although the... (Review)
Review
BACKGROUND
Spontaneous pneumomediastinum (SPM) is a rare condition defined by the presence of air in the mediastinum in the absence of traumatic or iatrogenic injury. Although the imaging findings and complications of SARS-CoV-2 infection have been reported many times, there are few reports of the prevalence and outcomes of patients with SPM.
PURPOSE
In this paper, we aimed to illustrate the different manifestations, management, and outcome of three cases of SPM in COVID-19 patients and provide an extensive review available literature.
MATERIALS AND METHODS
Detailed report of patients' demographics, clinical presentation, management, and outcome of three cases of COVID-19 induced SPM seen in our institution was provided. Additionally, literature search was employed through March 2021 using Pubmed and Google scholar databases where a total of 22 articles consisting of 35 patients were included.
RESULTS
Statistical analysis of the reviewed articles showed that SPM in COVID-19 occurs in patients with a mean age of 55.6 ± 16.7 years. Furthermore, 80% of the 35 patients are males and almost 60% have comorbidities. Intriguingly, SPM in COVID-19 is associated with a 28.5% mortality rate. These findings are consistent with our case series and are different from previous reports of SPM in non-COVID-19 cases where it most commonly occurs in younger individuals and has a self-limiting course with a good outcome.
CONCLUSION
Therefore, SPM in COVID-19 patients occurs in older patients and is potentially associated with a higher mortality rate. Further studies are necessary to assess its role as a prognostic marker of poor outcome.
Topics: Adult; Aged; COVID-19; Humans; Male; Mediastinal Emphysema; Mediastinum; Middle Aged; SARS-CoV-2; Tomography, X-Ray Computed
PubMed: 34391638
DOI: 10.1016/j.acra.2021.07.013 -
Critical Care Research and Practice 2021Iatrogenic pneumothoracis, barotraumas, and tracheoesophageal fistulae, especially after prolonged intubation, and tracheal stenosis are all entities involving thoracic...
INTRODUCTION
Iatrogenic pneumothoracis, barotraumas, and tracheoesophageal fistulae, especially after prolonged intubation, and tracheal stenosis are all entities involving thoracic surgeons' consultation and management. With the surge of COVID-19 cases particularly in the critical care settings, various types of complications have been observed that require intervention from thoracic surgeons.
METHODS AND MATERIALS
A retrospective study was conducted in an academic healthcare institute in the Eastern Province of Saudi Arabia. We included all COVID-19 cases admitted to ICU in the period between March 15, 2020, and August 15, 2020, requiring thoracic surgery consultation and management. Non-COVID-19 critical cases and iatrogenic pneumothorax were excluded.
RESULTS
Of 122 patients who were admitted to ICU with COVID-19, 18 patients (14.75%) required thoracic surgery consultation and management. We discovered a significant association between the outcomes and reintubation rates and the rate of pneumothorax occurrence. The survival analysis showed improvement in patients who had thoracostomy tube insertion as a management than the group who were treated conservatively. On the other hand, there was a significant difference between the COVID ICU group who had thoracic complication and those who did not regarding the length of hospital stay.
CONCLUSION
Noniatrogenic pneumothorax, subcutaneous emphysema, and mediastinal emphysema are well-known thoracic entities, but their presence in the context of COVID-19 disease is a harbinger for worse prognosis and outcomes. The presence of pneumothorax may be associated with better prognosis and outcome compared to surgical and mediastinal emphysema.
PubMed: 33815840
DOI: 10.1155/2021/6626150 -
Craniomaxillofacial Trauma &... Mar 2022Pneumomediastinum (PM) secondary to oromaxillofacial trauma (OMF) is a rare but well-described complication/pathologic finding. The aim of this study was twofold: first,... (Review)
Review
OBJECTIVES
Pneumomediastinum (PM) secondary to oromaxillofacial trauma (OMF) is a rare but well-described complication/pathologic finding. The aim of this study was twofold: first, to report our experience in treatment of maxillofacial trauma patients with PM, and second, to review the literature regarding the clinical features, severity, course, and management of the aforementioned complication.
MATERIAL AND METHODS
We retrospectively reviewed the medical records and charts of patients who suffered from maxillofacial trauma and treated in our hospital between September 1, 2013 and September 31, 2017. The inclusion criteria were patients with radiologically confirmed PM. In addition, the electronic databases PubMed, Scopus, and Science Direct were queried for articles reporting PM cases secondary to OMF injuries and published in English, French, and German language.
RESULTS
Three cases of PM out of 3,514 cases of craniomaxillofacial trauma were found; there were 3 male patients who presented in our emergency department with the chief complaint of cervicofacial swelling. Literature search isolated 58 selected articles and 63 cases were assessed in total; posttraumatic repeated blowing of nose was proved as most frequent triggering factor among them. Furthermore, the outcomes of review showed that thoracic pain, respiratory distress, and swallowing difficulties were not frequently reported in patients with ME due to facial trauma.
CONCLUSIONS
Both our experience and the results of systematic literature review indicated that patients with PM due to OMF injuries present mild clinical course. If properly managed, this specific pathologic condition may have no further complications or relative comorbidities. The exact etiology and mechanism of PM in the context of maxillofacial injuries always needs to be identified. Radiographic, laboratory, and endoscopic examinations should be applied to rule out the more serious and frequently diagnosed aerodigestive, thoracic, and abdominal causes of PM.
PubMed: 35265281
DOI: 10.1177/1943387521997236 -
Revista Do Instituto de Medicina... 2020Coronavirus Disease 2019 (COVID-19) has rapidly spread worldwide. Numerous studies have shown its typical and atypical CT findings. We report one COVID-19 patient who... (Review)
Review
Coronavirus Disease 2019 (COVID-19) has rapidly spread worldwide. Numerous studies have shown its typical and atypical CT findings. We report one COVID-19 patient who presented with a transient pneumothorax, spontaneous pneumomediastinum (SP), as well as subcutaneous emphysema during hospitalization. Chest CT andclinical findings were discussed, and a literature review is presented. The probable cause of SP in COVID-19 was alveolar damage. Once pneumothorax and SP were present, the patient should be carefully monitored to prevent respiratory deterioration, especially when lung lesions are severe.
Topics: Betacoronavirus; COVID-19; Coronavirus; Coronavirus Infections; Humans; Mediastinal Emphysema; Pandemics; Pneumonia, Viral; Pneumothorax; SARS-CoV-2; Subcutaneous Emphysema; Tomography, X-Ray Computed
PubMed: 33053145
DOI: 10.1590/S1678-9946202062076 -
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