-
Singapore Medical Journal Jun 2007A 21-year-old primigravida with previous history of pulmonary tuberculosis had a normal but assisted vaginal delivery after a prolonged second stage. Within 12 hours,...
A 21-year-old primigravida with previous history of pulmonary tuberculosis had a normal but assisted vaginal delivery after a prolonged second stage. Within 12 hours, she complained of dyspnoea and was found to have abnormal neck and anterior chest wall swelling. A diagnosis of subcutaneous emphysema was made and this was confirmed with the chest radiograph, which also revealed pneumomediastinum. She recovered well within four days with conservative treatment.
Topics: Adult; Dyspnea; Female; Humans; Labor Stage, Second; Mediastinal Emphysema; Obstetric Labor Complications; Postpartum Period; Pregnancy; Radiography; Subcutaneous Emphysema
PubMed: 17538741
DOI: No ID Found -
Deutsches Arzteblatt International Aug 2023
Topics: Humans; Mediastinal Emphysema
PubMed: 37721139
DOI: 10.3238/arztebl.m2022.0394 -
The New England Journal of Medicine Apr 2019
Topics: Adolescent; Asthma; Humans; Lung; Male; Mediastinal Emphysema; Radiography, Thoracic; Subcutaneous Emphysema
PubMed: 30970192
DOI: 10.1056/NEJMicm1811009 -
Acta Medica Academica Aug 2023The aim of the present series was first to present our experience in the management of 37 patients with spontaneous pneumomediastinum (SPM), and further to indicate the...
OBJECTIVE
The aim of the present series was first to present our experience in the management of 37 patients with spontaneous pneumomediastinum (SPM), and further to indicate the necessity of identifying true SPM cases as they are currently inadequately defined.
METHODS
This is a single-center, retrospective study, conducted in a university hospital. Consecutive adult patients with pneumomediastinum (PM) between January 2009 and March 2020 were involved in the series. The data about age, gender, symptoms, signs, treatment, length of hospital stay (LOS), and in-hospital mortality were evaluated.
RESULTS
In total, 87 cases with pneumomediastinum (37 with spontaneous and 50 with secondary PM) were analyzed. Patients in both groups were of similar ages (P=0.4). Sufferers with secondary PM were more likely to have: an associated pneumothorax (19% vs 58%, P<0.05), a chest tube placed (18.9% vs 58%, P<0.05), an associated pleural effusion (0% vs 18%, P<0.05). They presented with a longer LOS (3.9 vs 5.3 days, P<0.05), and were more likely to die (0% vs 10%, P<0.05). Additionally they showed a higher prevalence of radiologic subcutaneous emphysema (49% vs 74%, P<0.05).
CONCLUSION
Spontaneous pneumomediastinum is an onset of clinical importance with a low mortality rate, short LOS and good longterm prognosis. It often presents with chest pain, dyspnea and/or subcutaneous emphysema. However, secondary causes of mediastinal air must be ruled out, due to their potential devastating outcome if not diagnosed promptly. A consensus aimed at an update of the classification guidelines is more than indispensable.
Topics: Adult; Humans; Mediastinal Emphysema; Retrospective Studies; Dyspnea; Length of Stay; Subcutaneous Emphysema
PubMed: 37933505
DOI: 10.5644/ama2006-124.408 -
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 -
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 -
Annals of the Royal College of Surgeons... May 2007Ecstasy, also known as MDMA (3,4, methylenedioxymethamphetamine), is a popular illicit party drug amongst young adults. The drug induces a state of euphoria secondary to... (Review)
Review
INTRODUCTION
Ecstasy, also known as MDMA (3,4, methylenedioxymethamphetamine), is a popular illicit party drug amongst young adults. The drug induces a state of euphoria secondary to its stimulant activity in the central nervous system.
PATIENTS AND METHODS
A database review at two major inner city hospitals was undertaken to identify patients presenting with pneumomediastinum and their charts reviewed. A Medline review of all reported cases of pneumomediastinum associated with ecstasy abuse was undertaken.
RESULTS
A total of 56 patients presenting with pneumomediastinum were identified over a 5-year period. Review of the charts revealed a history of ecstasy use in the hours prior to presentation in six of these patients, representing the largest series reported to date.
CONCLUSIONS
Review of previously reported cases reveals the likely mechanism is due to Valsalva manoeuvre during periods of extreme physical exertion, and not a direct pharmacological effect of the drug.
Topics: Adolescent; Adult; Amphetamine-Related Disorders; Female; Hallucinogens; Humans; Male; Mediastinal Emphysema; N-Methyl-3,4-methylenedioxyamphetamine; Tomography, X-Ray Computed; Valsalva Maneuver
PubMed: 17535617
DOI: 10.1308/003588407X183373 -
Jornal Brasileiro de Pneumologia :... Jun 2020
Topics: Adult; Betacoronavirus; COVID-19; Coronavirus Infections; Humans; Male; Mediastinal Emphysema; Pandemics; Pneumonia, Viral; SARS-CoV-2; Tomography, X-Ray Computed
PubMed: 32556025
DOI: 10.36416/1806-3756/e20200190 -
Anales de Pediatria Apr 2019
Topics: Humans; Infant, Newborn; Mediastinal Emphysema; Subcutaneous Emphysema
PubMed: 29691133
DOI: 10.1016/j.anpedi.2018.03.011 -
Clinical Medicine (London, England) Jul 2022
Topics: COVID-19; Humans; Mediastinal Emphysema; Pneumothorax; SARS-CoV-2; Tomography, X-Ray Computed
PubMed: 36220238
DOI: 10.7861/clinmed.22-4-s51