scholarly journals Pneumomediastinum, Pneumoretroperitoneum, Pneumoperitoneum and Subcutaneous Emphysema Secondary to a Penetrating Anal Injury

Diagnostics ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. 707
Author(s):  
Yu-Ting Hsiao ◽  
Shyh-Wen Lin ◽  
Pei Wen Chuang ◽  
Ming-Jen Tsai
Keyword(s):  
Conservative Treatment ◽  
Subcutaneous Emphysema ◽  
Thermal Injury ◽  
Bowel Wall ◽  
Surgical Repair ◽  
Simultaneous Occurrence ◽  
Rectal Injury ◽  
Wall Defect ◽  
Subcutaneous Space ◽  
Body Compartments

Simultaneous occurrence of pneumoperitoneum, pneumoretroperitoneum, pneumomediastinum and subcutaneous emphysema is rare. The most reported mechanisms are barotrauma, thermal injury and instrument puncture caused by colonoscopy. Ectopic air may travel into different body compartments through distinct anatomical fascial planes. Definite curative treatment involves surgical repair of the bowel wall defect. Conservative treatment is available in selected patients. Here, we present a case of traumatic penetrating rectal injury leading to developing air in the peritoneum, retroperitoneum, mediastinum, and subcutaneous space with good recovery under conservative treatment.

Spontaneous otogenic pneumocephalus presenting with occipital subcutaneous emphysema as primary symptom: could tension gas cause the destruction of cranial bones?

2011 ◽  
Vol 115 (4) ◽  
pp. 679-683 ◽  
Author(s):  
Ninghui Zhao ◽  
Doris D. Wang ◽  
Xiaobin Huang ◽  
Surya K. Karri ◽  
Haiying Wu ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Subcutaneous Emphysema ◽  
Air Pressure ◽  
Air Leakage ◽  
Mechanical Compression ◽  
Tension Pneumocephalus ◽  
First Case ◽  
Subcutaneous Space

The authors report, to the best of their knowledge, the first case of a spontaneous tension pneumocephalus with subcutaneous emphysema. Hyperpneumatization of the cranium and mechanical compression contributed jointly to the formation of a fistula, and air pressure caused a subsequent disruption of the suture and air leakage into the subcutaneous space. A minimally invasive otological procedure proved efficacious for resolution.

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. 

Posttraumatic intercostal pulmonary herniation – case report

2021 ◽  
Vol 100 (5) ◽  
Keyword(s):  
Case Report ◽  
Chest Wall ◽  
Surgical Repair ◽  
Lung Parenchyma ◽  
Trauma Centre ◽  
Lower Limbs ◽  
Left Femur ◽  
Wall Defect ◽  
The Right ◽  
Car Accident

Introduction: Pulmonary hernias are rare conditions, most are the results of an injury or previous thoracic surgery. Case report: We present a case of a 48-year-old woman injured in a car accident. The examination in the trauma centre revealed a chest injury with herniation of the lung parenchyma into the chest wall and fractures of long bones of lower limbs. Initially, an osteosynthesis of the left femur and the right tibia fracture were performed. The patient underwent a subsequent surgery to repair the pulmonary hernia. Conclusion: A pulmonary hernia is diagnosed either directly during a clinical examination or by imaging. A sovereign diagnostic method is a computed tomography. The method of treatment is a surgical repair with primary suture of the chest wall defect or implantation of a mesh to repair the pulmonary hernia.

scholarly journals Benign versus life-threatening causes of pneumatosis intestinalis: differentiating CT features

2018 ◽  
Vol 64 (6) ◽  
pp. 543-548 ◽  
Author(s):  
Sujin Ko ◽  
Seong Sook Hong ◽  
Jiyoung Hwang ◽  
Hyun-joo Kim ◽  
Yun-Woo Chang ◽  
...  
Keyword(s):  
Bowel Wall ◽  
Statistical Significance ◽  
Pneumatosis Intestinalis ◽  
Bowel Distension ◽  
Wall Defect ◽  
Ct Findings ◽  
Free Air ◽  
Appropriate Treatment ◽  
Life Threatening ◽  
Ct Features

SUMMARY OBJECTIVE: To assess the diagnostic performance of CT findings in differentiating causes of pneumatosis intestinalis (PI), including benign and life-threatening causes. METHODS: All CT reports containing the word “pneumatosis” were queried from June 1st, 2006 to May 31st, 2015. A total of 42 patients with PI were enrolled (mean age, 63.4 years; 23 males and 19 females) and divided into two groups on based on electronic medical records: a benign group (n=24) and a life-threatening group (n=18). Two radiologists reviewed CT images and evaluated CT findings including bowel distension, the pattern of bowel wall enhancement, bowel wall defect, portal venous gas (PVG), mesenteric venous gas (MVG), extraluminal free air, and ascites. RESULTS: CT findings including bowel distension, decreased bowel wall enhancement, PVG, and ascites were more commonly identified in the life-threatening group (all p<0.05). All cases with PVG were included in the life-threatening group (8/18 patients, 44.4%). Bowel wall defect, extraluminal free air, and mesenteric venous gas showed no statistical significance between both groups. CONCLUSION: PI and concurrent PVG, bowel distension, decreased bowel wall enhancement, or ascites were significantly associated with life-threatening causes and unfavorable prognosis. Thus, evaluating ancillary CT features when we encountered PI would help us characterize the causes of PI and determine the appropriate treatment option.

A Neglected Cause of Iatrogenic Brachial Plexus Injuries in Psychiatric Patients

Neurosurgery ◽  
2017 ◽  
Vol 82 (3) ◽  
pp. 307-311 ◽  
Author(s):  
José Fernando Guedes-Corrêa ◽  
Maristella Reis da Costa Pereira ◽  
Francisco José Lourenço Torrão-Junior ◽  
José Vicente Martins ◽  
Daniel Alves Neiva Barbosa
Keyword(s):  
Bipolar Disorder ◽  
Conservative Treatment ◽  
Brachial Plexus ◽  
Surgical Repair ◽  
Psychiatric Patients ◽  
Third Parties ◽  
Intense Pain ◽  
Patient Demographics ◽  
Ultimate Outcome ◽  
Nerve Surgery

Abstract BACKGROUND Psychiatric patients are often kept immobilized during hospitalization to avoid self-inflicted injuries and danger to third parties. Inadequate positioning can lead to brachial plexus injuries (BPI). OBJECTIVE To present a series of 5 psychiatric patients with BPI after being left sedated and restrained for prolonged periods of time during hospitalization. METHODS We retrospectively reviewed the charts of 5 psychiatric patients with iatrogenic BPI referred by other institutions to our service. The restraint technique adopted by those institutions consisted of a high-thoracic restraint. All patients underwent complete clinical and neurological examination at our center. Information concerning patient demographics, BPI characteristics, treatment choice, and ultimate outcome was recorded. RESULTS Three patients were male. The age of our patients ranged from 25 to 61 years old (mean: 41.2; median: 43). Three patients had a diagnosis of bipolar disorder while 2 had schizophrenia. Duration of immobilization ranged from 5 to 168 h (mean: 77.8; median: 72). Four patients presented with a unilateral right-sided lesion. Time to presentation ranged from 1 to 9 mo (mean: 4.2; median: 4). All patients also had intense pain and axillary lesions. Four patients received conservative treatment with partial or full functional recovery and complete pain resolution. The remaining patients underwent surgical repair and experienced good functional outcome. CONCLUSION Psychiatric patients who need to be sedated and immobilized must be monitored closely, as BPI can occur from high-thoracic restraints. When such an injury occurs, the patient must be referred to a center specialized in peripheral nerve surgery and rehabilitation.

scholarly journals Anterior Lung Evisceration Following an Assault with Knife: A Case Report

2021 ◽  
Vol 5 (3) ◽  
pp. 335-340
Author(s):  
Martín Ferreira-Pozzi ◽  
Pablo Erramouspe ◽  
Juan Folonier ◽  
Mauro Perez ◽  
Daniel González ◽  
...  
Keyword(s):  
Case Report ◽  
Chest Trauma ◽  
Surgical Repair ◽  
Good Condition ◽  
Left Lung ◽  
Lung Parenchyma ◽  
Thoracic Wall ◽  
Initial Management ◽  
Wall Defect ◽  
Skin Coverage

Introduction: Evisceration of the lung is a rare consequence of open chest trauma that can be fatal. Evisceration of the lung refers to the protrusion of lung parenchyma through a defect of the thoracic wall, without parietal pleural or skin coverage. Case report: A 20-year-old man was brought to the emergency department (ED) with left lung evisceration from stab wounds. The eviscerated lung was left in place, and the patient was not intubated in the ED. He was immediately taken to the operating room (OR) for intubation and surgical repair. Other significant injuries were ruled out, the eviscerated lung was retrieved, the chest wall defect was closed, and the patient recovered well. He was discharged after seven days in good condition. Conclusion: The initial management of patients with lung evisceration is critical to prevent rapid decompensation and death. Appropriate ED airway management, lung retrieval in the OR, and thoracic wall repair is recommended for patients with lung evisceration.

Surgical repair of abdominal wall defect with biomimetic nano/microfibrous hybrid scaffold

2018 ◽  
Vol 93 ◽  
pp. 828-837 ◽  
Author(s):  
Wenbin Gong ◽  
Tao Cheng ◽  
Quanguo Liu ◽  
Qianru Xiao ◽  
Junsheng Li
Keyword(s):  
Abdominal Wall ◽  
Surgical Repair ◽  
Abdominal Wall Defect ◽  
Wall Defect ◽  
Hybrid Scaffold

Endoscopic view few days after TEF surgical repair, demonstrating the large membranous tracheal wall defect covered by using the bioabsorbable patch

ASVIDE ◽  
2018 ◽  
Vol 5 ◽  
pp. 575-575
Author(s):  
Giuseppe Marulli ◽  
Marco Mammana ◽  
Giuseppe Natale ◽  
Federico Rea
Keyword(s):  
Surgical Repair ◽  
Tracheal Wall ◽  
Wall Defect ◽  
Endoscopic View

Anatomical and Surgical Considerations on Lumbar Hernias

2009 ◽  
Vol 75 (12) ◽  
pp. 1238-1241 ◽  
Author(s):  
Giuseppe Cavallaro ◽  
Arash Sadighi ◽  
Claudia Paparelli ◽  
Mario Miceli ◽  
Giuseppe D'Ermo ◽  
...  
Keyword(s):  
Abdominal Wall ◽  
Surgical Repair ◽  
Abdominal Wall Defect ◽  
Open Approach ◽  
Wall Defect ◽  
Precise Knowledge ◽  
Good Cosmetic ◽  
Cosmetic Effect ◽  
Invasive Techniques ◽  
Anatomic Region

Lumbar hernias, which are rare hernias of the posterolateral abdominal wall, can be divided into two groups: primary lumbar hernias, often the expression of a congenital defect, which typically arise in two areas of weakness, the superior triangle and inferior triangle and acquired (or diffuse) lumbar hernias which are usually due to previous lumbar trauma or surgery. Clinical examination may be adjuvated by ultrasound or CT scan, which can reveal the abdominal wall defect with the hernia content (viscera or extraperitoneal tissue). Surgical repair of lumbar hernias, both primary and acquired, has rapidly developed through recent years, similarly to the treatment of more frequent kinds of hernia (groin, epigastric), evolving from direct repair to mini-invasive techniques, even if, since the rarity of these hernias, precise knowledge of this complex anatomic region is required. Nowadays there are two valid alternatives: open tension-free repair (with use of mesh), and mini-invasive repair. Both are safe and effective, even if smaller hernias can be treated by open approach, with loco-regional anesthesia and good cosmetic effect. Larger hernias, or hernias with suspected viscera involvement, should require larger incisions and viscera exploration. For this reason laparoscopic access would be preferable.

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