A rare situation: The association of spontaneous pneumomediastinum and pneumorrhachis

AbstractWe report on an 11-year-old girl with cystic fibrosis who presented with thoracic pain and an extensive subcutaneous emphysema and subsequently developed progressive respiratory distress. The chest computed tomography revealed a huge pneumomediastinum. Due to the development of severe respiratory failure, urgent needle thoracocentesis was necessary that resulted in only temporary improvement. Therefore, under general anesthesia two mediastinal drains were introduced. Using active suction, the size of the pneumomediastinum decreased gradually and the drains were removed after 3 weeks. Here, we describe an extremely rare situation, when acute surgical intervention was necessary in a child with spontaneous pneumomediastinum.

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Pneumomediastinum: A Rare Presentation of Inflicted Injuries in Infants

Journal of Pediatric Intensive Care ◽

10.1055/s-0040-1716857 ◽

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.

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Idiopathic Spontaneous Pneumomediastinum: Radiologic and Clinical Features

Journal of the Korean Radiological Society ◽

10.3348/jkrs.2004.51.1.55 ◽

2004 ◽

Vol 51 (1) ◽

pp. 55 ◽

Cited By ~ 1

Author(s):

Mi Young Kim ◽

Su Young Kim ◽

Yong Hoon Kim ◽

Yoon Joon Hwang ◽

Jung Wook Seo ◽

...

Keyword(s):

Clinical Features ◽

Spontaneous Pneumomediastinum

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Spontaneous Pneumomediastinum in pediatric patient

ACTUALIDAD MEDICA ◽

10.15568/am.2016.798.cd04 ◽

2016 ◽

Vol 101 (798) ◽

pp. 138-139

Author(s):

María Sierra Girón Prieto ◽

Irene Ibáñez Godoy

Keyword(s):

Pediatric Patient ◽

Spontaneous Pneumomediastinum

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22 Cases of Spontaneous Pneumomediastinum

Nihon Kikan Shokudoka Gakkai Kaiho ◽

10.2468/jbes.71.405 ◽

2020 ◽

Vol 71 (6) ◽

pp. 405-408

Author(s):

Ippei Yamana ◽

Jun Yanagisawa ◽

Shintaro Ryu ◽

Jun Ichikawa ◽

Nobuhiko Koreeda ◽

...

Keyword(s):

Spontaneous Pneumomediastinum

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Rectovaginal Fistula Due to Missing Intra Uterine Contraceptive Device

Nepal Journal of Obstetrics and Gynaecology ◽

10.3126/njog.v13i2.21706 ◽

2018 ◽

Vol 13 (2) ◽

pp. 64-66

Author(s):

Alexander Bambala Kawimbe

Keyword(s):

Rectovaginal Fistula ◽

Psychological Symptoms ◽

Control Measure ◽

Obstetric Care ◽

Contraceptive Device ◽

Poor Access ◽

Healthy Female ◽

Intrauterine Contraceptive ◽

Affected Woman ◽

Rare Situation

Rectovaginal fistula is an abnormal communication between the rectum and the vaginal. This leads to uncontrollable passage of feces and flatus through the vagina. It therefore causes distressing physical, social and psychological symptoms on the affected woman. The commonest cause of Rectovaginal Fistula is obstetric trauma commonly in developing countries with poor access to Obstetric care or substandard care provision. The case reported here highlights a rare situation in which a birth control measure of Intrauterine Contraceptive Device (IUD) in a 36 years old healthy female leads to a high Rectovaginal fistula.Keywords: fecal incontinence, missing IUD, rectovaginal fistula

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Spontaneous Pneumomediastinum: Uncommon Cause of Air Leak in Late Preterm Neonate

Journal of Neonatology ◽

10.1177/09732179211023763 ◽

2021 ◽

Vol 35 (2) ◽

pp. 93-94

Author(s):

Jyotsna Bhushan ◽

Shagufta Iqbal ◽

Abhishek Chopra

Keyword(s):

Respiratory Distress ◽

Conservative Management ◽

Preterm Neonate ◽

Late Preterm ◽

Intravenous Fluids ◽

X Rays ◽

Blood Gas ◽

X Ray ◽

Spontaneous Pneumomediastinum ◽

Chest X Ray

A clinical case report of spontaneous pneumomediastinum in a late-preterm neonate, chest x-ray showing classical “spinnaker sail sign,” which was managed conservatively and had excellent prognosis on conservative management. Respiratory distress in a preterm neonate is a common clinical finding. Common causes include respiratory distress syndrome, transient tachypnea of the newborn, pneumonia, and pneumothorax. Pneumomediastinum is not very common cause of respiratory distress and more so spontaneous pneumomediastinum. We report here a preterm neonate with spontaneous pneumomediastinum who had excellent clinical recovery with conservative management. A male baby was delivered to G3P1A1 mother at 34 + 6 weeks through caesarean section done due to abruptio placenta. Apgar scores were 8 and 9. Maternal antenatal history was uneventful and there were no risk factors for early onset sepsis. Baby had respiratory distress soon after birth with Silverman score being 2/10. Baby was started on oxygen (O2) by nasal prongs through blender 0.5 l/min, FiO2 25%, and intravenous fluids. Blood gas done was normal. Possibility of transient tachypnea of newborn or mild hyaline membrane disease was kept. Respiratory distress increased at 20 h of life (Silverman score: 5), urgent chest x-ray done revealed “spinnaker sign” suggestive of pneumomediastinum, so baby was shifted to O2 by hood with FiO2 being 70%. Blood gas repeated was normal. Baby was managed conservatively on intravenous fluids and O2 by hood. Baby was gradually weaned off from O2 over next 5 days. As respiratory distress decreased, baby was started on orogastric feed, which baby tolerated well and then was switched to oral feeds. Serial x-rays showed resolution of pneumomediastinum. Baby was discharged on day 7 of life in stable condition on breast feeds and room air.

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Simultaneous spontaneous pneumomediastinum and pneumopericardium in a critically ill patient with COVID-19

Radiology Case Reports ◽

10.1016/j.radcr.2021.07.062 ◽

2021 ◽

Author(s):

Mohammad Javad Behzadnia ◽

Abbas Samim ◽

Fatemeh Saboori ◽

Mosa Asadi ◽

Mohammad Javanbakht

Keyword(s):

Critically Ill ◽

Critically Ill Patient ◽

Spontaneous Pneumomediastinum

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Spontaneous pneumomediastinum and pneumorrhachis in a healthy girl

BMJ Case Reports ◽

10.1136/bcr-2020-241077 ◽

2021 ◽

Vol 14 (2) ◽

pp. e241077

Author(s):

Jorge Rodrigues ◽

Raquel Monteiro Costa ◽

Joana Magalhães ◽

Elisabete Santos

Keyword(s):

Spontaneous Pneumomediastinum

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Spontaneous Pneumomediastinum, Pneumothorax, Pneumopericardium and Subcutaneous Emphysema—Not So Uncommon Complications in Patients with COVID-19 Pulmonary Infection—A Series of Cases

Journal of Clinical Medicine ◽

10.3390/jcm10071346 ◽

2021 ◽

Vol 10 (7) ◽

pp. 1346

Author(s):

Talida Georgiana Cut ◽

Cristina Tudoran ◽

Voichita Elena Lazureanu ◽

Adelina Raluca Marinescu ◽

Raluca Dumache ◽

...

Keyword(s):

Mechanical Ventilation ◽

Subcutaneous Emphysema ◽

Diffuse Alveolar Damage ◽

Demographic Data ◽

Pathophysiological Mechanism ◽

Spontaneous Pneumomediastinum ◽

Intensive Care Stay ◽

Laboratory Investigations ◽

Male Patients ◽

Pulmonary Pathology

(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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