Subcutaneous Emphysema with Spontaneous Pneumomediastinum and Pneumothorax in Adult Dermatomyositis

(1) Background: Spontaneous pneumomediastinum (PM), pneumothorax (PT), and pneumopericardium (PP) were recently reported as rare complications in patients with severe COVID-19 pneumonia, and our study aims to follow the evolution of these involvements in 11 cases. The presumed pathophysiological mechanism is air leak due to extensive diffuse alveolar damage followed by alveolar rupture. (2) Methods: We followed the occurrence of PM, PN, PP, and subcutaneous emphysema (SE) in 1648 patients hospitalized during the second outbreak of COVID-19 (October 2020–January 2021) in the main hospital of infectious diseases of our county and recorded their demographic data, laboratory investigations and clinical evolution. (3) Results: Eleven patients (0.66%) developed PM, with eight of them having associated PT, one PP, and seven SE, in the absence of mechanical ventilation. Eight patients (72.72%) died and only three (27.27%) survived. All subjects were nonsmokers, without known pulmonary pathology or risk factors for such complications. (4) Conclusions: pneumomediastinum, pneumothorax, and pneumopericardium are not so uncommon complications of SARS-CoV2 pneumonia, being observed mostly in male patients with severe forms and associated with prolonged hospitalization and poor prognosis. In some cases, with mild forms and reduced pulmonary injury, the outcome is favorable, not requiring surgical procedures, mechanical ventilation, or intensive care stay.

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An Interesting Case of Spontaneous Pneumomediastinum with Subcutaneous Emphysema following Oral Provocative Manoeuvre

Otorhinolaryngology Clinics - An International Journal ◽

10.5005/jp-journals-10003-1200 ◽

2015 ◽

Vol 7 (2) ◽

pp. 93-96 ◽

Cited By ~ 1

Author(s):

CB Pratibha ◽

Deepthi Satish ◽

Suraj Gopal

Keyword(s):

Foreign Body ◽

Subcutaneous Emphysema ◽

Rare Condition ◽

Interesting Case ◽

Valsalva Manoeuvre ◽

Laryngeal Edema ◽

Airway Compromise ◽

Air Leak ◽

Spontaneous Pneumomediastinum ◽

Laryngeal Involvement

ABSTRACT Aim To discuss a case of spontaneous pneumomediastinum with pneumothorax with subcutaneous emphysema presenting with stridor due to laryngeal edema with relevant review of literature. Background Spontaneous pneumomediastinum is a rare condition that has been described in healthy individuals following Valsalva manoeuvre, excessive and prolonged cough or emesis. Laryngeal involvement in these cases has not been reported so far. Case description We present an interesting case of spontaneous pneumomediastinum with pneumothorax with pneumopericardium and cervicofacial emphysema with suspected ingestion of foreign body. In view of stridor due to laryngeal edema tracheostomy was done. No obvious cause for the air leak was found on further investigations. The foreign body sensation could have led to oral provocative manoeuvres by the patient causing increased intra-alveolar pressures and air leak. Conclusion Spontaneous pneumomediastinum with cervicofacial emphysema with pneumopericardium with laryngeal involvement is very rare. Tracheostomy is essential in case of airway compromise. A thorough evaluation for the underlying condition is essential to prevent further air leak. Clinical significance In a case of spontaneous pneumomediastinum with airway compromise due to involvement of the larynx, tracheostomy is essential to secure the airway and could also help in resolution of emphysema. How to cite this article Pratibha CB, Satish D, Gopal S, Balasubramanya AM. An Interesting Case of Spontaneous Pneumomediastinum with Subcutaneous Emphysema following Oral Provocative Manoeuvre. Int J Otorhinolaryngol Clin 2015;7(2):93-96.

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Spontaneous Pneumomediastinum and Subcutaneous Emphysema: Unusual Presentation of H1N1 Influenza in Adult

10.9734/bpi/nfmmr/v8/3677f ◽

2021 ◽

pp. 151-158

Author(s):

Naorem Dhaneshwor Singh ◽

Jaswinder Kaur ◽

Desh Deepak ◽

Lobzang Dawa

Keyword(s):

Subcutaneous Emphysema ◽

H1n1 Influenza ◽

Unusual Presentation ◽

Spontaneous Pneumomediastinum

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Spontaneous pneumomediastinum and subcutaneous emphysema in a child with unknown aetiology

BMJ Case Reports ◽

10.1136/bcr-2018-226805 ◽

2019 ◽

Vol 12 (2) ◽

pp. e226805

Author(s):

Anoopkishore Chidambaram ◽

Sirisha Donekal

Keyword(s):

Subcutaneous Emphysema ◽

Rare Entity ◽

X Ray ◽

Spontaneous Pneumomediastinum ◽

Expert Opinions ◽

Repeat Chest ◽

Chest X Ray ◽

Red Flag ◽

Surgical Emphysema ◽

Safety Netting

Spontaneous subcutaneous emphysema and pneumomediastinum in children without any predisposing factors is a rare entity. We present a case of an adolescent boy with spontaneous pneumomediastinum. He is a 14-year-old boy brought to the hospital with an odd feeling in the neck and chest. Initial chest X-ray revealed subcutaneous emphysema and pneumomediastinum. He was further evaluated with CT thorax and abdomen with contrast which revealed extensive pneumomediastinum with associated surgical emphysema in the chest wall and neck. Expert opinions from the cardiothoracic and respiratory teams were obtained. The child was discharged with safety netting and description of red flag signs. Repeat chest X-ray in 2 weeks showed complete resolution of the pneumomediastinum and subcutaneous emphysema. We will briefly discuss about the diagnosis and treatment of spontaneous pneumomediastinum and subcutaneous emphysema.

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Pediatric Spontaneous Pneumomediastinum after a Push-Up Exercise: An Uncommon Complication of a Common Exercise

Children ◽

10.3390/children7120287 ◽

2020 ◽

Vol 7 (12) ◽

pp. 287

Author(s):

Chih-Yi Tsay ◽

Yu-Long Chen ◽

Chien-Sheng Chen ◽

Po-Chen Lin ◽

Meng-Yu Wu

Keyword(s):

Early Diagnosis ◽

Airway Obstruction ◽

Subcutaneous Emphysema ◽

Therapeutic Strategies ◽

Lung Pathology ◽

Spontaneous Pneumomediastinum ◽

Uncommon Condition ◽

Uncommon Complication ◽

Push Up

Pediatric spontaneous pneumomediastinum is an uncommon condition associated with infection, trauma, or coexisting structural lung pathology. Exercise-related spontaneous subcutaneous emphysema and pneumomediastinum are rarely reported. However, severe pneumomediastinum may coexist with pneumothorax, pneumorrhachis, and subcutaneous emphysema, which can potentially lead to serious complications, including airway obstruction and pneumorrhachis. Therefore, early diagnosis and timely management are important for physicians to determine the etiology and prevent further damage. Here, we present a case of exercise-related spontaneous subcutaneous emphysema and pneumomediastinum to highlight the pathogenesis and suggest therapeutic strategies.

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