1/13. Suck and spit, don't blow: orbital emphysema after decompression surgery.PURPOSE: To describe the occurrence of vision-threatening orbital emphysema in patients awakening from orbital decompression surgery and to assess risk factors and preventive measures. DESIGN: Small noncomparative case series. PARTICIPANTS: Three patients undergoing bilateral orbital two-wall decompression experienced significant orbital emphysema associated with persistent coughing and Valsalva at the time of extubation. INTERVENTION: In two patients, symptoms resolved with simple observation, whereas one patient required sedation, topical anesthesia around the endotracheal tube, and needle decompression of trapped air. MAIN OUTCOME MEASURES: visual acuity, pupils, visual fields, and sensorimotor examination. RESULTS: No patient experienced a permanent deficit of visual or sensorimotor function. CONCLUSIONS: Acute orbital emphysema can occur after orbital decompression surgery despite the large bony opening created. Violent coughing spells at the time of extubation are more common in patients with a history of heavy tobacco use and may be causative. Opening the periorbita may be another specific predisposing risk factor. knowledge of this dangerous phenomenon, along with appropriate perioperative management, may prevent this complication from occurring.- - - - - - - - - - ranking = 1keywords = emphysema (Clic here for more details about this article) |
2/13. Asymptomatic expectoration of surgical staples complicating lung volume reduction surgery.lung volume reduction surgery (LVRS) has recently been introduced as a palliative treatment for patients with severe emphysema. The most common postoperative complication is persistent air leak requiring prolonged tube thoracostomy. We describe a unique case of a patient with severe emphysema who underwent LVRS and presented, about a year later, with the repeated expectoration of surgical staples.- - - - - - - - - - ranking = 0.28571428571429keywords = emphysema (Clic here for more details about this article) |
3/13. Spontaneous compressive orbital emphysema of rhinogenic origin.We report the case of a young patient who developed spontaneous compressive orbital emphysema after an attack of coughing. At admission the patient presented left proptosis, diplopia, vision impairment and headache. Computer tomography showed air in the lateral part of left orbit compressing the eyeball and the optic nerve medially. It also revealed a sphenoid bone dysplasia with hyperpneumatization of the left greater wing and with two dehiscences in its wall. It was very intriguing to discover that this sphenoid dysplasia and the flap of mucosa covering one dehiscence were causing a ball-valve effect, allowing air to enter but not leave the orbit. Endoscopic sinus surgery was successfully used to treat this case.- - - - - - - - - - ranking = 0.71428571428571keywords = emphysema (Clic here for more details about this article) |
4/13. subcutaneous emphysema after associated colonoscopy and transanal excision of rectal adenoma.Non-traumatic subcutaneous emphysema (NSE) is a rare complication of procedures of the digestive tract. To the best of our knowledge, it has never been reported to occur after transanal surgery. Herein we present the first known case of NSE accompanied by retropneumoperitoneum and pneumomediastinum to develop after colonoscopy and full-thickness transanal removal of a rectal polyp.- - - - - - - - - - ranking = 0.71428571428571keywords = emphysema (Clic here for more details about this article) |
5/13. Spontaneous tracheal rupture: a case report.We report the case of a spontaneous posterior tracheal wall rupture following a cough. A 67-year-old woman with a history of longstanding treatment with corticosteroids (8 years) for giant cell arteritis had general anesthesia for cataract removal. Surgery and anesthesia were uneventful. In the recovery room, the patient coughed and soon after developed subcutaneous emphysema of the neck. Chest radiography confirmed the clinical diagnosis of marked subcutaneous emphysema and showed huge pneumomediastinum and minor right pneumothorax. A thoracic CT scan revealed a large laceration of the posterior tracheal wall (a 4 cm longitudinal tear), extending from the middle of the trachea to the level of the carina. Surgical repair consisted in closure of the dilaceration using an autologous pericardial patch. It seems reasonable to suspect the facilitating role of connective tissue fragility due to chronic corticosteroid administration in the development of this tracheal rupture following cough. Tracheal rupture is a potentially lethal injury, which can be repaired successfully if the diagnosis is made early. risk factors, diagnosis and principles of treatment of this lesion are discussed.- - - - - - - - - - ranking = 0.28571428571429keywords = emphysema (Clic here for more details about this article) |
6/13. Multiple rheumatoid nodules with rapid thin-walled cavity formation producing pneumothorax.We report a rare case of multiple rheumatoid nodules that on chest CT demonstrated peripheral location with thin-walled cavity formation, rapid increase in size within several months, and complicating pneumothorax, pneumomediastinum, and subcutaneous emphysema due to bronchopleural fistula formation.- - - - - - - - - - ranking = 0.14285714285714keywords = emphysema (Clic here for more details about this article) |
7/13. hemoptysis and coughing up of staples as a late complication of volume reduction surgery for emphysema.Three patients with very similar clinical symptoms, i.e. hemoptysis and coughing up of staples some time after volume-reducing surgery, are described. There was no deterioration in lung function, nor in the patient's well-being, which could be ascribed to the coughing up of the staples. Thus, staples can some time after volume reducing surgery erode out into the bronchi and be coughed up, often with some small amounts of blood. This has no clinical significance other than the disturbing symptoms. Possibly, the calf pericardium used as strenghtener of the suture lines will with time cause an immunological reaction, causing destruction of the foreign material and thereby dislodging the staples.- - - - - - - - - - ranking = 0.57142857142857keywords = emphysema (Clic here for more details about this article) |
8/13. Spontaneous tracheal rupture after severe coughing in a 7-year-old boy.Tracheal lacerations are rare but potentially life-threatening. They are recognized sequelae of cervical or thoracic injuries or complications of endotracheal intubation. Spontaneous tracheal rupture is extremely uncommon and has not been reported in a pediatric patient. This report is the first pediatric case of a spontaneous longitudinal laceration of the posterior membranous cervical trachea, which occurred after violent coughing in a 7-year-old boy with acute tracheobronchitis. The tracheal rupture was detected early with an endoscopic examination and computed tomography. The rupture and emphysema were small, with no major complications, and disappeared with conservative management. This rare case is presented with a review of the possible mechanism, diagnosis, and treatment.- - - - - - - - - - ranking = 0.14285714285714keywords = emphysema (Clic here for more details about this article) |
9/13. Cryptogenic constrictive bronchiolitis. A clinicopathologic study.Four women with a chronic respiratory illness characterized by chronic cough, dyspnea, mild to severe physiologic abnormalities, relatively normal chest radiographs, and lack of response to bronchodilators or prednisone were identified and prospectively evaluated. Constrictive bronchiolitis, defined as concentric narrowing of the bronchiolar lumen, mural scarring, smooth muscle hyperplasia, and mucus stasis, was the major histologic finding on open lung biopsy in all cases. Each presented with an illness clinically distinct from asthma, connective tissue disorders, occupational or environmental lung disease, bronchiectasis, diffuse panbronchiolitis, cystic fibrosis, and emphysema. None of the patients smoked cigarettes. None had clinical evidence of a recent viral lower respiratory tract infection. The physical examinations were normal except for rales heard on chest examination in two patients. Chest radiographs showed increased bronchovascular markings in three patients. lung function was normal in one patient, two of the patients had a reduced diffusing capacity associated with moderate hypoxemia and an obstructive ventilatory defect, and one patient exhibited a mixture of restrictive and obstructive defects. None have experienced significant progression of their disease over 1 to 5 yr of follow-up. However, complete return to normal function did not occur. We hypothesize that patients with the constellation of findings described represent a distinct and definable clinicopathologic entity and further clarifies the spectrum of "small airways disease." Establishing the diagnosis appears important for prognostic and possibly therapeutic reasons.- - - - - - - - - - ranking = 0.14285714285714keywords = emphysema (Clic here for more details about this article) |
10/13. subcutaneous emphysema: a complication of surgery and anesthesia.subcutaneous emphysema is an iatrogenic complication by which air is introduced into the tissues either during or immediately after surgery. A case is presented that demonstrates the complication, following the removal of third molars, believed to be due to violation of the maxillary sinus, an underinflated cuff of a nasotracheal tube, and coughing on extubation.- - - - - - - - - - ranking = 0.71428571428571keywords = emphysema (Clic here for more details about this article) |
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