scholarly journals Spontaneous Pneumomediastinum with a Rare Presentation

2014 ◽  
Vol 2014 ◽  
pp. 1-3 ◽  
Author(s):  
Ehsan Bolvardi ◽  
Elham Pishbin ◽  
Mohsen Ebrahimi ◽  
Azadeh Mahmoudi Gharaee ◽  
Farhad Bagherian
Keyword(s):  
Subcutaneous Emphysema ◽  
Vital Signs ◽  
Physical Exertion ◽  
Rare Presentation ◽  
Benign Condition ◽  
Spontaneous Pneumomediastinum ◽  
Free Air ◽  
Close Observation ◽  
Chest Examination ◽  
History Of

Spontaneous pneumomediastinum is an unusual and benign condition in which air is present in mediastinum. A 20-year-old male patient presented to ED with complaint of hoarseness and odynophagia from the day before, after weightlifting. The patient was nonsmoker and denied history of other diseases. On physical examination he had no dyspnea with normal vital signs. Throat examination and pulmonary auscultation were normal and no crepitation was palpable. We could not find subcutaneous emphysema in neck and chest examination. In neck and chest X-ray we found that air is present around the trachea. There was no apparent pneumothorax in CXR. In cervical and chest CT free air was present around trachea and in mediastinum. Subcutaneous emphysema was also evident. But there was no pneumothorax. The patient was admitted and went under close observation, oxygen therapy, and analgesic. The pneumomediastinum and subcutaneous emphysema gradually resolved within a week by conservative therapy and he was discharged without any complication. Many different conditions could be trigged because of pneumomediastinum but it is rarely seen in intense physical exertion such as weightlifting and bodybuilding. Two most common symptoms are retrosternal chest pain and dyspnea. But the patient here complained of hoarseness and odynophagia.

Pneumomediastinum: A Rare Presentation of Inflicted Injuries in Infants

2020 ◽  
Author(s):  
Adam Lee ◽  
Adam Bajinting ◽  
Abby Lunneen ◽  
Colleen M. Fitzpatrick ◽  
Gustavo A. Villalona
Keyword(s):  
Literature Review ◽  
Retrospective Review ◽  
Review Of The Literature ◽  
Rare Presentation ◽  
Spontaneous Pneumomediastinum ◽  
Nonaccidental Trauma ◽  
Comprehensive Literature Review ◽  
Healthy Infants ◽  
History Of

AbstractReports of incidental pneumomediastinum in infants secondary to inflicted trauma are limited. A retrospective review of infants with pneumomediastinum and history of inflicted trauma was performed. A comprehensive literature review was performed. Three infants presented with pneumomediastinum associated with inflicted trauma. Mean age was 4.6 weeks. All patients underwent diagnostic studies, as well as a standardized evaluation for nonaccidental trauma. All patients with pneumomediastinum were resolved at follow-up. Review of the literature identified other cases with similar presentations with related oropharyngeal injuries. Spontaneous pneumomediastinum in previously healthy infants may be associated with inflicted injuries. Clinicians should be aware of the possibility of an oropharyngeal perforation related to this presentation.

scholarly journals Spontaneous Pneumomediastinum from Running Sprints

2010 ◽  
Vol 2010 ◽  
pp. 1-4 ◽  
Author(s):  
Joseph W. Turban
Keyword(s):  
Physical Activity ◽  
Lung Cancer ◽  
Asthma Exacerbation ◽  
Rare Condition ◽  
Intrathoracic Pressure ◽  
Benign Condition ◽  
Spontaneous Pneumomediastinum ◽  
Free Air ◽  
Life Threatening ◽  
Intense Physical Activity

Spontaneous pneumomediastinum (SPM) is a fairly rare condition, caused by increased intrathoracic pressure, leading to free air in the mediastinal structures. Underlying lung conditions are associated with increased incidence of SPM, including asthma, interstitial lung disease, pneumonia, bullous lung, and radiation therapy for lung cancer. It is often preceded by Valsalva maneuvers, vomiting, coughing, asthma exacerbation, sneezing, childbirth, or intense physical activity. A case of SPM is presented in a 15-year-old male, who complained of throat pain and dyspnea while running sprints at football practice. Workup revealed SPM, and he was subsequently admitted and treated conservatively. His symptoms resolved in 2 days and he was discharged and suffered no further recurrences. In contrast to secondary pneumomediastinum, SPM is usually a benign condition although life-threatening conditions can rarely arise. Differentiating between these two conditions has important prognostic indications. There is a paucity of prospectively collected data regarding SPM, and considerable variation in recommendations concerning the extent of workup.

A case of Fournier’s gangrene diagnosed with POCUS

POCUS Journal ◽  
2019 ◽  
Vol 4 (1) ◽  
pp. 3
Author(s):  
Marco Badinella Martini, MD ◽  
Antonello Iacobucci, MD
Keyword(s):  
Type 2 Diabetes ◽  
Emergency Department ◽  
Alzheimer Disease ◽  
Physical Examination ◽  
Subcutaneous Emphysema ◽  
Vital Signs ◽  
Fournier’S Gangrene ◽  
Fournier's Gangrene ◽  
History Of

An 87-year-old man with a history of type 2 diabetes and severe Alzheimer disease was admitted to the emergency department with a lesion of the perineum for two days. The patient appeared agitated and not collaborating on the visit. His vital signs were normal. Physical examination revealed an edematous, suppurative, and foul-smelling perineal-scrotal lesion, with possible subcutaneous emphysema.

scholarly journals Spontaneous pneumomediastinum, pneumothorax and subcutaneous emphysema in COVID-19 patients—a case series

2021 ◽  
Vol 52 (1) ◽  
Author(s):  
Akshat Agrawal ◽  
Kamal Kumar Sen ◽  
Gitanjali Satapathy ◽  
Humsheer Singh Sethi ◽  
Ajay Sharawat ◽  
...  
Keyword(s):  
Subcutaneous Emphysema ◽  
Case Series ◽  
Prior History ◽  
Invasive Ventilation ◽  
Computed Tomography Scan ◽  
Case Presentation ◽  
Spontaneous Pneumomediastinum ◽  
History Of ◽  
Time Of Admission ◽  
Tomography Scan

Abstract Background Spontaneous pneumomediastinum, pneumothorax and spontaneous subcutaneous emphysema are rare entities. A rising trend in the setting of COVID-19 even in patients who are not put on invasive ventilation can suggest an alternative aetiology. Case presentation We describe four cases which presented with suspected symptoms of COVID-19 and were diagnosed with pneumomediastinum, pneumothorax, and subcutaneous emphysema which would have been missed if not for computed tomography scan performed at the time of admission. Three of these cases had no prior history of any iatrogenic intervention, and the fourth person developing pneumothorax and subcutaneous emphysema after intubation. Conclusions Pneumomediastinum, pneumothorax and subcutaneous emphysema can be noted as a complication of COVID-19 itself as well as the complication of management of COVID-19.

scholarly journals An Unusual Association in an Uncommon Disease: Two Cases of Spontaneous Pneumomediastinum Associated with Pneumorrhachis

2016 ◽  
Vol 2016 ◽  
pp. 1-3
Author(s):  
Luís Martins ◽  
Patrícia Dionísio ◽  
Susana Moreira ◽  
Alda Manique ◽  
Isabel Correia ◽  
...  
Keyword(s):  
Subcutaneous Emphysema ◽  
Clinical Condition ◽  
Interventional Procedures ◽  
Trauma Surgery ◽  
Spontaneous Pneumomediastinum ◽  
Unusual Association ◽  
Free Air ◽  
Uncommon Disease

Pneumomediastinum, the presence of free air in the mediastinum, is described as spontaneous pneumomediastinum when there is no apparent cause such as trauma, surgery, interventional procedures, or intrathoracic infections. Pneumorrhachis is a rare clinical condition, consisting of intraspinal air. The main causes are iatrogenic, traumatic, and nontraumatic. Spontaneous mediastinum is usually associated with subcutaneous emphysema and, occasionally, with pneumothorax; however, its association with pneumorrhachis is extremely rare. Here, we present two rare cases of spontaneous pneumomediastinum associated with pneumorrhachis caused by vigorous coughing.

scholarly journals Spontaneous Pneumopericardium in a U.S. Marine: Do not Lose Heart

2019 ◽  
Vol 185 (3-4) ◽  
pp. e518-e521
Author(s):  
David Sherrier ◽  
Radhames E Lizardo
Keyword(s):  
Subcutaneous Emphysema ◽  
Military Service ◽  
Fast Track ◽  
Unusual Case ◽  
Vital Signs ◽  
Marine Corps ◽  
Hilly Terrain ◽  
Military Service Members ◽  
Elevation Changes ◽  
History Of

Abstract We report an unusual case of extensive subcutaneous emphysema, pneumomediastinum, and pneumopericardium identified in an otherwise healthy U.S. Marine who was enrolled in the Marine Corps School of Infantry. His training regimen included prolonged periods of yelling and elevation changes during sustained hiking through hilly terrain. The patient presented to the Fast Track with normal vital signs but complained of dyspnea, cough, and subjective fevers. Although he lacked a history of trauma, he was found to have pneumopericardium, pneumomediastinum, and subcutaneous emphysema without pneumothorax. He was admitted to the general surgery service for observation and was ultimately released back to his unit after 24 hours. To our knowledge, pneumopericardium has never been attributed to persistent yelling in the setting of a lower respiratory tract infection and should be considered in the differential of atraumatic chest symptomatology in otherwise healthy military service members.

scholarly journals P17: PNEUMOMEDIASTINUM A RARE COMPLICATION OF COLONOSCOPY POLYPECTOMY SUCCESSFULLY TREATED WITH CONSERVATIVE MANAGEMENT

2016 ◽  
Vol 64 (3) ◽  
pp. 823.3-824
Author(s):  
C Rives ◽  
M Pourmorteza ◽  
E Carter ◽  
M Young
Keyword(s):  
Computed Tomography ◽  
Conservative Management ◽  
Subcutaneous Emphysema ◽  
Rare Complication ◽  
Vital Signs ◽  
Stable Condition ◽  
High Morbidity ◽  
Mortality And Morbidity ◽  
Packed Red Blood Cells ◽  
Free Air

Purpose of StudyColonoscopies are a relatively safe and are associated with few complications. We present a rare case of post-colonoscopy polypectomy resulting in a pneumomediastinum and subcutaneous emphysema.Methods UsedAn 84 year old male with a history of colonoscopy with polypectomy the day prior was admitted due to a syncopal episode. The only complaint was a small amount of dark red blood per rectum. On examination vital signs were stable, the patient appeared pale with dry membrane mucosa, abdominal and pulmonary exam were benign, labs were concerning for a Hgb 6.9 g/dl. Chest X-ray depicted free air beneath the right hemidiaphragm, computed tomography demonstrated pneumoretroperitoneum, pneumomediastinum and subcutaneous emphysema. Visceral angiogram failed to demonstrate any source of active bleeding. Due to the overall stable condition of the patient conservative management with prophylactic zosyn and transfusion of 2 units of packed red blood cells was initiated. Patient was discharged 5 days after admission with stable respiratory and hemodynamic signs.Summary of ResultsDiagnostic colonoscopies are relatively safe procedures with the most common complications being bleeding and perforations, with an incidence of less than .2%. Though perforations are rare they are associated with a high mortality and morbidity. Causes of perforation can be due to excessive insufflations, instrumental trauma and usually present with intra-abdominal free air but rarely with a pneumomediastinum. A pneumomediastinum is the presence of free air within the mediastinum and in our case was due to a micro-perforation from a colonic polypectomy. The colonic wall defect allowed free air into the retroperitoneum, which spread along the fascial planes and entered the mediastinum and subcutaneous tissues. The most sensitive test for pneumomediastinum is computed tomography and extra-pulmonary causes of pneumomediastinum can be successfully treated conservatively with rest and antibiotics.ConclusionsThough complications from polypectomies are rare, they can be associated with a high morbidity and mortality but rarely associated with pneumomediastinum and in certain stable patients can be treated with conservative management.

scholarly journals Pneumomediastinum Associated with Pneumopericardium and Epidural Pneumatosis

2014 ◽  
Vol 2014 ◽  
pp. 1-4 ◽  
Author(s):  
Ozlem Bilir ◽  
Ozcan Yavasi ◽  
Gokhan Ersunan ◽  
Kamil Kayayurt ◽  
Baris Giakoup
Keyword(s):  
Chest Wall ◽  
Subcutaneous Emphysema ◽  
Specific Treatment ◽  
Pediatric Intensive Care ◽  
Anterior Chest Wall ◽  
Benign Condition ◽  
Spontaneous Pneumomediastinum ◽  
Life Threatening ◽  
Lateral Chest ◽  
Physical Findings

Spontaneous pneumomediastinum is a relatively rare benign condition. It may rarely be associated with one or combination of pneumothorax, epidural pneumatosis, pneumopericardium, or subcutaneous emphysema. We present a unique case with four of the radiological findings in a 9-year-old male child who presented to our emergency department with his parents with complaints of unproductive cough, dyspnea, and swelling on chest wall. Bilateral subcutaneous emphysema was palpated on anterior chest wall from sternum to midaxillary regions. His anteroposterior and lateral chest radiogram revealed subcutaneous emphysema and pneumomediastinum. His thorax computed tomography to rule out life-threatening conditions revealed bilateral subcutaneous, mediastinal, pericardial, and epidural emphysema without pneumothorax. He was transferred to pediatric intensive care unit for close monitorization and conservative treatment. He was followed-up by chest radiographs. He was relieved from symptoms and signs around the fifth day and he was discharged at the seventh day. Diagnosis of pneumomediastinum is often made based on physical findings and plain radiographs. It may not be as catastrophic as it is seen. Close cardiopulmonary monitorization is mandatory for complications and accompanying conditions. Most patients with uncomplicated spontaneous pneumomediastinum respond well to oxygen and conservative management without any specific treatment.

scholarly journals Long term complications following polyacrylamide hydrogel breast augmentation: a case report and review of the literature

2021 ◽  
Vol 8 (3) ◽  
pp. 994
Author(s):  
Justin J. Weller
Keyword(s):  
Breast Augmentation ◽  
Polyacrylamide Hydrogel ◽  
Careful Monitoring ◽  
Rare Presentation ◽  
Increased Risk ◽  
Close Observation ◽  
Operative Planning ◽  
Institutional Experience ◽  
History Of ◽  
Magnetic Resonance Imaging Mri

Complications from Polyacrylamide hydrogel breast augmentation (PHBA) are a rare cause for presentation in Australia. I reviewed the literature and analysed our institutional experience in order to familiarise clinicians with this rare procedure. I present the case of a 44 year-old female with a three-year history of intermittent right lateral breast pain. She had a background of breast augmentation with Interfall Gel in China in 2000. She was tender over the lateral aspect of her breast which was exacerbated by physical activity. An magnetic resonance imaging (MRI) revealed areas of extravasation bilaterally with no suspicious lesions and the specialist opinion was for close observation in six months. Although a rare presentation, Australia’s population has many emigrates from Asian nations and further presentations are to be expected. The literature clearly supports the importance of careful monitoring of these patients, due to the potential for severe complications such as infection, sepsis, breast auto-inflation, significant tenderness and possibly increased risk of breast malignancy. MRI is also crucial in evaluating these cases, namely to rule out malignancy and for pre-operative planning in severe cases. However, the majority of presentations are suitable for careful monitoring.

Spontaneous pneumomediastinum: an uncommon clinical problem with a potential for missed or delayed diagnosis

2021 ◽  
Vol 14 (2) ◽  
pp. e238700
Author(s):  
Clare Treharne ◽  
Holli Coleman ◽  
Arunachalam Iyer
Keyword(s):  
Subcutaneous Emphysema ◽  
Delayed Diagnosis ◽  
Clinical Problem ◽  
Upper Gastrointestinal Endoscopy ◽  
Oral Contrast ◽  
Delay In Diagnosis ◽  
Spontaneous Pneumomediastinum ◽  
Facial Swelling ◽  
History Of ◽  
Upper Abdomen

A 15-year-old man presented with an acute history of facial swelling following a bout of forceful eructation after eating. Subcutaneous emphysema was noted on examination of his left face and neck. He was initially managed with intravenous antibiotics for suspected facial infection. A chest radiograph performed on day 3 of admission identified subcutaneous emphysema of the upper thorax and neck. CT with oral contrast confirmed extensive subcutaneous emphysema of neck, thorax and upper abdomen, with associated pneumomediastinum. The site of air leak was not identified. He subsequently underwent upper gastrointestinal endoscopy and this was normal. Despite the delay in diagnosis, he remained haemodynamically stable, and repeated radiography showed improvement reflecting the benign course of this condition as described in existing literature. There are no previous published reports of spontaneous pneumomediastinum following eructation; therefore, high clinical suspicion should be maintained in this presentation.

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