Air leak syndrome as one of the manifestations of bronchiolitis obliterans organizing pneumonia.
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A 46-year-old man developed respiratory distress with air leak syndrome (ALS), including pneumothorax, pneumomediastinum, and subcutaneous emphysema. Open lung biopsy was performed and revealed the histopathologic evidence of bronchiolitis obliterans organizing pneumonia (BOOP), which responded well to steroid treatment. As far as we know, this appears to be the first case of BOOP presenting with ALS as one of its major complications. (+info)
Cutaneous emphysema and craniocervical bone pneumatization.
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We report a case of pneumatization of the upper cervical spine and the craniocervical junction, including the occipital bone, accompanied by extensive soft tissue emphysema. There was no history of trauma or surgery. Follow-up X-ray and CT demonstrated the development of those changes. A combination of a developmental abnormality and the unusual habit of frequent Valsalva's maneuvers may have led to those findings. Clinical consequences will be discussed. (+info)
Subcutaneous emphysema of upper limb.
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A case is reported of subcutaneous emphysema involving upper limb resulting from a trivial laceration to the elbow. Gas in the soft tissues after the injury can be caused by infection with a gas forming organism or by a variety of non-infective causes. It is hypothesised that this minor skin wound has acted like a ball-valve mechanism leading to air being trapped in the soft tissue. (+info)
Transtracheal high frequency jet ventilation for endoscopic airway surgery: a multicentre study.
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Serious complications during high frequency jet ventilation (HFJV) are rare and have been documented in animals and in case reports or short series of patients with a difficult airway. We report complications of transtracheal HFFJV in a prospective multicentre study of 643 patients having laryngoscopy or laryngeal laser surgery. A transtracheal catheter could not be inserted in two patients (0.3%). Subcutaneous emphysema (8.4%) was more frequent after multiple tracheal punctures. There were seven pneumothoraces (1%), two after laser damage to the injector, one after difficult laryngoscopy, four with no clear cause. Arterial desaturation of oxygen was more frequent during laser surgery and in overweight patients. Transtracheal ventilation from a ventilator with an automatic cut-off device is a reliable method for experienced users. Control of airway pressure does not prevent a low frequency of pneumothorax. (+info)
Comparative study of mediastinal emphysema as determined by etiology.
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OBJECTIVE: To evaluate the difference in the clinical features of mediastinal emphysema as classified into three groups based on etiology; patients in whom it was spontaneous with unknown etiology (A group), those in whom it was secondary to bronchial asthma (B group), and those in whom it was secondary with other respiratory diseases (C group). PATIENTS: Forty-three cases (45 episodes) with mediastinal emphysema treated at Kawasaki Medical School Kawasaki Hospital between April 1985 and March 2000 (A group: 17 cases, B group: 17 cases, C group: 9 cases). RESULTS: The average ages of the A and B groups were of little significance. Most of the patients in the A group were males with a thin body. Three patients in the A group had episodes of pneumothorax or mediastinal emphysema in their past history. Five patients in the A group had Hamman's sign on physical examination. In all of the patients in the C group, mediastinal emphysema was accompanied by subcutaneous emphysema, whereas only eight patients in the A group had subcutaneous emphysema. The prognosis was good for A and B groups because the mediastinal emphysema disappeared within 10 days, but was poor in the C group because its disappearance was very late compared with that in the other two groups and skin incision was required in three patients in the C group due to severe subcutaneous emphysema. CONCLUSIONS We suggest that the existance and kind of underlying diseases significantly affect the method of treatment and the prognosis. (+info)
Subcutaneous emphysema and pneumomediastinum as presenting manifestations of neonatal tracheal injury.
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Neonatal tracheal injury/perforation is an uncommon complication of traumatic deliveries or endotracheal intubation. We present a case of neonatal tracheal injury following delivery at term that presented with subcutaneous emphysema and pneumomediastinum before any attempt at intubation. The clinical course, treatment, and outcome are described. (+info)
Subcutaneous emphysema of the neck and colonic perforation.
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Subcutaneous emphysema may result from pathological changes in the thorax or lung, as a result of localised infection with gas producing organisms, after abdominal procedures, or herald an intestinal perforation. The location and spread of extraperitoneal gas is determined by the anatomical barriers and fixed fascial layers surrounding the region of pathological change. The case highlights the extent of extraperitoneal gas after colonic perforation despite minimal clinical features and the importance of intra-abdominal causes of cervical subcutaneous emphysema. (+info)
Subcutaneous emphysema after tonsillectomy: a case report.
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We experienced a case of a subcutaneous emphysema after tonsillectomy. The patient, a 24-year-old man, complained of a recurrent sore throat and was diagnosed as having chronic tonsillitis. Pre-operative general examinations revealed no abnormalities. The operation was carried out under general anesthesia. The adhesions between the tonsils and the surrounding tissues were moderate. The bi-lateral tonsils were easily removed. The recovery period was uneventful. On the next morning, marked swelling of the left cheek and submandibular area was noted. On palpation, there was a characteristic crepitation and softness in these areas. The X-ray examination revealed subcutaneous emphysema. There was no finding of airway obstruction. We diagnosed him as having a subcutaneous emphysema and administered antibiotics for 5 days. From clinical findings, the subcutaneous emphysema was thought to be caused by surgical rather than anesthetic factors. The subcutaneous emphysema gradually disappeared. One year after the tonsillectomy, the patient is under observation as an outpatient and is free from any abnormal symptoms. To avoid this kind of complication, we should pay attention to carefully separate the tonsil from its fossa and to make appropriate selection of surgical equipments. (+info)