scholarly journals Ginkgo leaf sign on X-ray chest due to subcutaneous emphysema in a COVID-19 patient

2021 ◽  
Vol 8 (8) ◽  
pp. 1223
Author(s):  
Ashish Behera ◽  
Mohan Kumar H. ◽  
Rohit Bakshi ◽  
Arihant Sharma
Keyword(s):  
Subcutaneous Emphysema ◽  
Sudden Change ◽  
X Ray ◽  
Direct Trauma ◽  
Rare Manifestation ◽  
Subcutaneous Space ◽  
Pectoralis Muscles ◽  
Chest X Ray ◽  
Airway Access ◽  
Ginkgo Leaf

Subcutaneous emphysema (SE) is usually encountered in cases of structural lung diseases and secondary to direct trauma or iatrogenic procedures for airway access. It is mostly associated with pneumothorax. The diagnosis is made clinically by palpation of the affected area and radiology. Here we presented a case of COVID-19 pneumonia presenting with extensive subcutaneous emphysema resulting in airway compression which was a very rare manifestation of COVID-19 infection. The COVID-19 infection led to extensive alveolar damage to the lungs and the chronic cough which may have led to this complication due to sudden change of pressure differences in the chest wall cavity. The limitation of using of personal protective equipments hindered the diagnosis of this condition as auscultation and the palpatory feelings were greatly hindered. The chest X-ray shows air in subcutaneous space and the prominence of the fibres of bilateral pectoralis muscles which gives an impression of the venous system of a Ginkgo leaf, so named as Ginkgo leaf sign. 

Management of an unusual presentation of foreign body aspiration

1992 ◽  
Vol 106 (8) ◽  
pp. 751-752 ◽  
Author(s):  
Hassan H. Ramadan ◽  
Nicolas Bu-Saba ◽  
Anis Baraka ◽  
Salman Mroueh
Keyword(s):  
Foreign Body ◽  
Subcutaneous Emphysema ◽  
Positive Pressure Ventilation ◽  
Intermittent Positive Pressure Ventilation ◽  
Foreign Body Aspiration ◽  
Positive Pressure ◽  
Review Of The Literature ◽  
X Ray ◽  
Post Surgery ◽  
Chest X Ray

AbstractForeign body aspiration is a very common problem in children and toddlers and still a serious and sometimes fatal condition. We are reporting on a 2-year-old white asthmatic male who choked on a chick pea and presented with subcutaneous emphysema, and on chest X-ray with an isolated pneumomediastinum but not pneumothorax. On review of the literature an isolated pneumomediastinum without pneumothorax was rarely reported. This presented a challenge in management mainly because of the technique that we had to use in order to undergo bronchoscopy and removal of the foreign body. Apnoeic diffusion oxygenation was used initially while the foreign body was removed piecemeal, and afterwards intermittent positive pressure ventilation was used. The child did very well, and his subcutaneous emphysema and pneumomediastinum remarkably improved immediately post surgery.

scholarly journals Subcutaneous Emphysema in Pregnancy

2011 ◽  
Vol 51 (183) ◽  
Author(s):  
A Shrestha ◽  
S Acharya
Keyword(s):  
Subcutaneous Emphysema ◽  
Late Pregnancy ◽  
X Ray ◽  
Close Observation ◽  
The Face ◽  
Normal Chest ◽  
Chest X Ray ◽  
Keywords Pregnancy ◽  
Systemic Examination ◽  
The Right

Spontaneous pneumomediastinum and subcutaneous emphysema are rare complications of labor, especially in the late pregnancy period, but they are usually self-limiting. Management includes avoidance of exacerbative factors and close observation with supportive treatment. A 19-year-old primi gravida at 36 weeks pregnancy presented with swelling over the right side of the face, neck and chest. Her general examination was normal. Systemic examination revealed swelling with palpatory crepitation over the right side of chest, neck and face, and other examination findings were normal. Chest X-ray revealed subcutaneous emphysema without pneumothorax. The patient left hospital against medical advice. Keywords: Pregnancy; subcutaneous emphysema; pneumomediastinum.

scholarly journals Spontaneous pneumomediastinum and subcutaneous emphysema in a child with unknown aetiology

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.

scholarly journals Pneumomediastinum and subcutaneous emphysema: complication of cocaine use

2019 ◽  
Vol 12 (10) ◽  
pp. e229205
Author(s):  
Filipa de Sousa Costeira ◽  
Filipa Vieira ◽  
Fernanda Marta Gomes ◽  
Carolina Leite
Keyword(s):  
Subcutaneous Emphysema ◽  
Illicit Drugs ◽  
Chest Trauma ◽  
Young Men ◽  
Respiratory Complications ◽  
X Ray ◽  
Healthy Man ◽  
Adjacent Structures ◽  
Chest X Ray ◽  
Complementary Study

Pneumomediastinum is more frequent in young men and usually presents in association with subcutaneous emphysema. It can occur in case of oesophageal or chest trauma, be iatrogenic or develop spontaneously, in case of emesis, coughing or forceful straining. Use of illicit drugs, such as cocaine, has been associated with multiple respiratory complications, including pneumomediastinum and subcutaneous emphysema. The pathogenesis of subcutaneous emphysema and pneumomediastinum after cocaine inhalation is not completely known, but it is thought that the physical manoeuvers used to increase its absorption and effect may lead to alveolar rupture, resulting in air escaping into the mediastinum and fascial planes of the neck and chest. Chest X-ray is usually diagnostic, but CT can be used as complementary study, allowing evaluation of adjacent structures. A case of pneumomediastinum and subcutaneous emphysema after cocaine inhalation in an otherwise healthy man is presented.

scholarly journals Pneumomediastinum and pneumopericardium in an adolescent with asthma attacks. Case report

Case reports ◽  
2020 ◽  
Vol 6 (1) ◽  
pp. 63-69
Author(s):  
María Fernanda Ochoa-Ariza ◽  
Jorge Luis Trejos-Caballero ◽  
Cristian Mauricio Parra-Gelves ◽  
Marly Esperanza Camargo-Lozada ◽  
Marlon Adrián Laguado-Nieto
Keyword(s):  
Case Report ◽  
Chest Pain ◽  
Subcutaneous Emphysema ◽  
Respiratory Symptoms ◽  
Laboratory Tests ◽  
Young Patients ◽  
Clinical Suspicion ◽  
X Ray ◽  
Chest X Ray ◽  
The Right

Introduction: Pneumomediastinum is defined as the presence of air in the mediastinal cavity. This is a rare disease caused by surgical procedures, trauma or spontaneous scape of air from the lungs; asthma is a frequently associated factor. It has extensive differential diagnoses due to its symptoms and clinical signs.Case presentation: A 17-year-old female patient presented with respiratory symptoms for 2 days, dyspnea, chest pain radiated to the neck and shoulders, right supraclavicular subcutaneous emphysema, wheezing in both lung fields, tachycardia and tachypnea. On admission, laboratory tests revealed leukocytosis and neutrophilia, and chest X-ray showed subcutaneous emphysema in the right supraclavicular region. Diagnosis of pneumomediastinum was confirmed through a CT scan of the chest. The patient was admitted for treatment with satisfactory evolution.Discussion: Pneumomediastinum occurs mainly in young patients with asthma, and is associated with its exacerbation. This condition can cause other complications such as pneumopericardium, as in this case. The course of the disease is usually benign and has a good prognosis.Conclusion: Because of its presentation, pneumomediastinum requires clinical suspicion to guide the diagnosis and treatment. In this context, imaging is fundamental.

Cardiac instability due to Pneumomediastinum during second stage of labour

2009 ◽  
Vol 54 (2) ◽  
pp. 58-58
Author(s):  
J Rafi ◽  
H Muppala ◽  
B Schaefer
Keyword(s):  
Subcutaneous Emphysema ◽  
Case Reports ◽  
Neck Region ◽  
High Dependency Unit ◽  
X Ray ◽  
Second Stage ◽  
Cardiovascular Instability ◽  
Second Stage Of Labour ◽  
High Dependency ◽  
Chest X Ray

This case reports spontaneous pneumomediastinum in the second stage of labour leading to cardiovascular instability. Forceps were used to expedite delivery. Examination revealed characteristic crepitus of subcutaneous emphysema in the neck region, which was confirmed on chest X-Ray and CT scan. The patient was managed in the high dependency unit (HDU) for 48 hours and made a full recovery.

scholarly journals Hamman’s Syndrome: A Rare Cause of Chest Pain in a Postpartum Patient

2015 ◽  
Vol 2015 ◽  
pp. 1-4 ◽  
Author(s):  
Daniyeh Khurram ◽  
Brijesh Patel ◽  
M. Waseem Farra
Keyword(s):  
Subcutaneous Emphysema ◽  
Valsalva Maneuver ◽  
Diagnostic Technique ◽  
Rare Condition ◽  
Benign Condition ◽  
X Ray ◽  
Life Threatening ◽  
Subcutaneous Tissues ◽  
Chest X Ray ◽  
Tissue Diffusion

Hamman’s syndrome is a rare condition represented by spontaneous pneumomediastinum and subcutaneous emphysema. Excessive Valsalva maneuver during vaginal delivery and excessive retching, coughing, and straining are frequently reported causes. The incidence of Hamman’s syndrome is believed to be 1 in 100,000 deliveries. The pathophysiology of this condition is rupture of alveoli and seepage of air through bronchovascular connective tissue. Diffusion of air to subcutaneous tissues results in subcutaneous emphysema. In most cases, it is a benign condition and resolves spontaneously. In life-threatening cases, a cardiac tamponade can ensue. Chest X-ray is a useful early diagnostic technique. We report a case of a twenty-four-year-old female who was diagnosed with Hamman’s syndrome after prolonged, exhaustive labor.

scholarly journals A case of subcutaneous emphysema/mediastinal emphysema during the use of humidified high-flow nasal cannula

2019 ◽  
Vol 5 (1) ◽  
Author(s):  
Shota Sonobe ◽  
Satoki Inoue ◽  
Tadashi Nishiwada ◽  
Junji Egawa ◽  
Masahiko Kawaguchi
Keyword(s):  
Subcutaneous Emphysema ◽  
Oxygen Therapy ◽  
High Flow ◽  
Nasal Cannula ◽  
High Flow Nasal Cannula ◽  
Respiratory Condition ◽  
Case Presentation ◽  
X Ray ◽  
Chest X Ray ◽  
High Flows

Abstract Background Heated, humidified, high-flow nasal cannula (HHFNC) oxygen therapy allows optimal humidification of inspired gas at high flows and creates a distending pressure similar to nasal continuous positive airway pressure [1]. It has been safely used in adults with moderate hypoxemia with few complications [2, 3]. Hereby, we report serious complications occurred during HHFNC oxygen therapy. Case presentation A 53-year-old female with hemophagocytic lymphohistiocytosis (HLH) was admitted to the intensive care unit because of respiratory failure. After weaning from mechanical ventilation which lasted for 2 weeks, HHFNC therapy at 40 L/min with an FiO2 of 0.5 was started for hypoxemia. Four days later, dyspnea and hypoxemia occurred and chest X-ray and CT scan revealed localized pneumothorax, subcutaneous emphysema, and massive pneumomediastinum. After cessation of HHFNC, respiratory condition improved. Conclusion Subcutaneous emphysema, pneumothorax, and pneumomediastinum should be notified as a serious complication during HHFNC therapy.

scholarly journals Cocaine-Induced Pneumopericardium: Safe for Discharge? A Case Report and Literature Review

2019 ◽  
Vol 2019 ◽  
pp. 1-4 ◽  
Author(s):  
Xavier Galloo ◽  
Jan Stroobants ◽  
David Yeo ◽  
Esmael El-Abdellati
Keyword(s):  
Subcutaneous Emphysema ◽  
Cocaine Abuse ◽  
Blood Analysis ◽  
Conservative Approach ◽  
X Ray ◽  
Thoracic Ct ◽  
Intranasal Cocaine ◽  
Chest X Ray ◽  
The Right

A 29-year-old male presented at the Emergency Department (ED) with chest pain and neck tenderness after intranasal cocaine usage. Physical exam of the patient demonstrated moderate subcutaneous emphysema on the right side of his neck. The ECG did not demonstrate any changes associated with cocaine-induced cardiac ischemia, and blood analysis was normal (negative troponins). A chest X-ray revealed subtle evidence of pneumomediastinum. Subsequent thoracic CT confirmed the presence of subcutaneous emphysema with a pneumopericardium and a large pneumomediastinum along with a small pneumothorax. The patient was managed conservatively and kept overnight for observation. He was discharged from the ED the following day with ambulatory follow-up. A repeat thoracic CT performed two weeks later demonstrated that the findings identified in the first CT had resolved. Pneumopericardium, -mediastinum, and -thorax are rare conditions reported after cocaine abuse. A conservative approach with a period of observation in a suitable ambulatory unit is acceptable, as current literature suggests that the condition is usually self-limiting.

scholarly journals Comparison of chest drainage tube types (24Fr silastic vs. thoracic catheter) after lung resection

2020 ◽  
Author(s):  
Tai Hato ◽  
Masatoshi Yamaguchi ◽  
Hiroaki Kashimada ◽  
Ato Sugiyama ◽  
Yoshiaki Inoue ◽  
...  
Keyword(s):  
Subcutaneous Emphysema ◽  
Lung Resection ◽  
Patient Characteristics ◽  
Chest Drainage ◽  
X Ray ◽  
Chest Drainage Tube ◽  
Single Lumen ◽  
Postoperative Drainage ◽  
Chest X Ray ◽  
Water Seal

Abstract Background: Silastic drains (SDs) are widely used for postoperative chest drainage. We performed a direct comparison of SDs and conventional single-lumen thoracic catheters (TCs) with similar sizes.Methods: We performed a historically controlled retrospective study. SDs (24 Fr in size) were used for postoperative drainage from September 2017 to May 2018, and TCs (24 or 28Fr) were used from June 2018 to March 2019. Drainage tubes were maintained with a water seal alone. A comparison was performed of the volume and the speed of fluid until 48 hrs after surgery, the undrained area on chest X-ray, expansion of subcutaneous emphysema, and the duration of drainage.Results: One hundred fifty-eight patients with SDs and one hundred fifty-five patients with TCs were included. The patient characteristics were equivalent between the groups. The median length of drainage was two days for both groups. The fluid drainage speed was similar between the groups. While the incidence of expansion of subcutaneous emphysema was equivalent for both groups, reinsertion of drainage tubes was more frequent in the SD group due to insufficient air drainage.Conclusions: SDs and TCs have almost equivalent drainage performances. For patients with a risk of massive air leakage, SDs should be avoided.

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