Challenging chest drainage: a case report

Introduction. Chest trauma is one of the most common causes of death corresponding to 20 to 25 % of cases. The majority of the patients (85%), can be managed with only a tube thoracostomy. Our objective by presenting this case report is to provide an example of how to manage a challenging chest tube thoracostomy in a patient with cardiac hernia diagnosed in the preoperative phase, based on signs of computed tomography. Case report. A 45-year-old male presented to our emergency department who fell from a light pole 7 meters high. He fell to the ground on his back. Physical examination revealed a huge subcutaneous emphysema on his entire anterior chest wall and presented no sensitivity or movements below the navel line. After the initial assessment and management care, the patient improved. As the patient stabilized we decided to go to CT. The scan revealed pericardial rupture with only the right pericardial circumference intact, the heart herniated into the left pleural space, bilateral pneumothorax, small right hemothorax and a relevant subcutaneous emphysema surrounding the chest. We decided to perform the blunt dissection technique to insert chest tubes bilaterally because of safety. After performed it the patient was transferred to cardiothoracic department. Discussion. There is a variety of techniques to perform tube thoracostomy but the blunt dissection remain the safer, especially when we are facing an anatomic distortion of the heart. Conclusion. We present a case report of a challenging thoracic drainage performed in a patient with traumatic cardiac hernia, which procedure was successful.

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Spontaneous orbital subcutaneous emphysema mimicking lacrimal duct obstruction after sneezing: A case report

Hong Kong Journal of Emergency Medicine ◽

10.1177/1024907918797530 ◽

2018 ◽

Vol 27 (3) ◽

pp. 176-179

Author(s):

Hung-Yen Chan ◽

Chon-Fu Lio ◽

Chang-Ching Yu ◽

Nan-Jing Peng ◽

Hung-Pin Chan

Keyword(s):

Case Report ◽

Subcutaneous Emphysema ◽

Relevant Information ◽

Lacrimal Duct ◽

Case Presentation ◽

Duct Occlusion ◽

Painful Sensation ◽

Eyelid Swelling ◽

Visual Problems ◽

The Right

Introduction: Orbital subcutaneous emphysema after trauma has been carefully reported, but its development in the absence of trauma is rare. Case presentation: We report on a 70-year-old patient who developed unilateral orbital subcutaneous emphysema, mimicking lacrimal duct occlusion, after this man sneezed, and presented with right crepitant eyelid swelling and progressive ptosis. Orbital subcutaneous emphysema develops when air can get into the periorbital soft tissue, which presents as a result of facial bone trauma, iatrogenic procedures, and gas-forming infectious microorganisms, as seen in many published articles. It is very uncommon to see this kind of case report after sneezing; however, in our case, spontaneous orbital subcutaneous emphysema occurred after sneezing that resolved slowly after a few weeks without surgical intervention. Our patient denied any painful sensation over the right orbital area, including no visual problems with the right eye but right eyeball limited movements. It can be stressful to patients due to its symptoms but is not a true emergency. Conclusion: In this article, we should bring awareness to physicians of the possibility of a spontaneously orbital subcutaneous emphysema with complications after sneezing, yielding relevant information for patients to be informed about avoid excessive nose blowing or occluding the nose, creating controlled symptoms.

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Computed tomography-guided tube thoracostomy for massive subcutaneous emphysema following lung resection: a case report

AME Case Reports ◽

10.21037/acr.2019.04.03 ◽

2019 ◽

Vol 3 ◽

pp. 11-11

Author(s):

Toshinari Ema ◽

Hiroshi Neyatani ◽

Saki Yamamoto ◽

Shuhei Iizuka ◽

Kazuhito Funai ◽

...

Keyword(s):

Computed Tomography ◽

Case Report ◽

Subcutaneous Emphysema ◽

Lung Resection ◽

Tube Thoracostomy

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

Case reports ◽

10.15446/cr.v6n1.81485 ◽

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.

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Unilateral rectus sternalis muscle - a case report

National Journal of Clinical Anatomy ◽

10.1055/s-0039-3401606 ◽

2016 ◽

Vol 05 (03) ◽

pp. 172-175

Author(s):

Smitha S Nair ◽

K Jayasree ◽

Ashalatha PR ◽

Jenish Joy

Keyword(s):

Case Report ◽

Surgical Procedures ◽

Pectoralis Major Muscle ◽

Anatomical Variations ◽

Anterior Chest Wall ◽

Superficial Fascia ◽

Anatomical Variant ◽

Incorrect Diagnosis ◽

The Right ◽

Sternalis Muscle

AbstractRectus sternalis muscle, either unilateral or bilateral is an uncommon anatomical variant among the anterior chest wall muscles. During the routine dissection as a part of undergraduate medical teaching in the department of Anatomy, a unilateral rectus sternalis muscle was noticed on the right hemi thorax in one cadaver, located adjacent to the sternum between the pectoralis major muscle and the superficial fascia of the region. Though rare in occurrence, when present, rectus sternalis muscle demands proper awareness and attention by the clinicians especially radiologists and surgeons, as the ignorance of the existence of this muscle may lead to misinterpretation, incorrect diagnosis and unnecessary clinical interventions. Such anatomical variations should be borne in mind while doing radiological investigations, radiotherapy and surgical procedures in the chest region.

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