1/3. Esophageal laceration and charcoal mediastinum complicating gastric lavage.A 19-year-old woman underwent multiple attempts at orogastric lavage before success 5 h after ingesting approximately 24 grams of ibuprofen in a suicide attempt. Activated charcoal was administered via the lavage tube. She vomited charcoal shortly after administration and began experiencing difficulty breathing and an increase in the pitch of her voice. A chest X-ray study showed a widened mediastinum, pneumopericardium, and subcutaneous emphysema consistent with esophageal perforation that was confirmed by computed tomography scan. Surgical exploration revealed a tear in the proximal posterior esophagus with charcoal in the posterior mediastinum. She remained intubated for 7 days and was discharged 14 days after admission. This is a report of esophageal perforation with activated charcoal contamination of the mediastinum after gastric lavage. The risks and benefits of this procedure should be carefully considered in each patient prior to its use. Awake patients should be cooperative with the procedure to minimize any risk of trauma to the oropharynx or esophagus.- - - - - - - - - - ranking = 1keywords = emphysema (Clic here for more details about this article) |
2/3. subcutaneous emphysema of upper limb.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.- - - - - - - - - - ranking = 5keywords = emphysema (Clic here for more details about this article) |
3/3. 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 = 1keywords = emphysema (Clic here for more details about this article) |