Cases reported "Mediastinal Emphysema"

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1/24. Spontaneous pneumomediastinum in an 18-year-old black Sudanese high school student.

    Spontaneous pneumomediastinum (SPM) is defined as pneumomediastinum in the absence of an underlying lung disease. It is the second most common cause of chest pain in young, healthy individuals (< 30 years) necessitating hospital visits. It is surpassed in frequency in this setting only by spontaneous pneumothorax. These two conditions may coexist in 18% of patients. The incidence of spontaneous pneumomediastinum varies in different communities and generally is relatively uncommon. Inhalational drug use (cocaine and cannabis) have been associated with a significant number of cases, although cases with no apparent etiologic or incriminating factors are well recognized. Also its recurrence, though uncommon, is worthy of note. It is a benign clinical condition with diverse clinical presentations. physicians' knowledge of the presentation, treatment, and prognosis of SPM will guard against the need for expensive radiologic and laboratory tests. The differential diagnosis of chest pain, shortness of breath, and dysphagia include cardiac, pulmonary, and esophageal diseases. The tendency to pursue these entities may lead to laboratory investigations such as electrocardiograms, arterial blood gases, ventilation/perfusion scans, and contrast radiographic studies of the esophagus.
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2/24. Oesophageal rupture in a patient with postoperative nausea and vomiting.

    rupture of the oesophagus (Boerhaave's syndrome) is a rare complication of forceful or suppressed vomiting. postoperative nausea and vomiting is common but does not usually lead to life-threatening complications. A case of oesophageal rupture in a man who experienced postoperative nausea and vomiting after an uncomplicated procedure is described in this report. delayed diagnosis mandated conservative treatment. The clinical presentation, diagnosis and management of oesophageal rupture is discussed.
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3/24. Cervical emphysema, pneumomediastinum, and pneumothorax following self-induced oral injury: report of four cases and review of the literature.

    Spontaneous rupture of the pulmonary alveoli after a sudden increase in intra-alveolar pressure is a common cause of pneumomediastinum, which is usually seen in healthy young men. Other common causes are traumatic and iatrogenic rupture of the airway and esophagus; however, pneumomediastinum following cervicofacial emphysema is much rarer and is occasionally found after dental surgical procedures, head and neck surgery, or accidental trauma. We present four cases of subcutaneous emphysema and pneumomediastinum with two secondary pneumothoraces after self-induced punctures in the oral cavity. They constitute an uncommon clinical entity that, to our knowledge, has not been reported in the literature. Its radiologic appearance, clinical presentation, and diagnosis are described.
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4/24. Pneumomediastinum secondary to an apparently trivial stab wound to the neck: the value of the Hamman's sign and thorough radiological investigation.

    Perforation of the pharynx and upper oesophagus after stab wounds to the neck is easily overlooked because of the relative lack of symptoms. A case is reported in which pneumomediastinum occurred after an apparently trivial neck wound.
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5/24. Pneumomediastinum due to intractable hiccup as the presenting symptom of multiple sclerosis.

    Pneumomediastinum and subcutaneous emphysema generally occurs following trauma to the esophagus or lung. It also occurs spontaneously in such situations of elevating intra-thoracic pressure as asthma, excessive coughing or forceful straining. We report here on the rare case of a man who experienced the signs of pneumomediastinum and subcutaneous emphysema after a prolonged bout of intractable hiccup as the initial presenting symptoms of multiple sclerosis.
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6/24. Pneumomediastinum and abdominal pain: which correlation?

    The case of a female patient with abdominal pain, fever and dyspnea appeared abruptly, is reported. Two days previously the patient underwent endoscopic colic polypectomy. Preliminary abdominal and chest X-ray showed colic and tenual air-fluid levels, a modest amount of pneumomediastinum and soft tissue emphysema of the neck. The cause of the latter finding was referable to five sites of origin: the lung parenchyma, mediastinal airways, the esophagus, the neck and the abdominal cavity. For symptom worsening thoracoabdominal CT was performed. It confirmed the pneumomediastinum and soft tissue emphysema of the neck and presence of intra and retroperitoneal free air as for perforation. colonoscopy is a routine procedure in the diagnosis and therapy of colonopathies, but colic iatrogenic perforation is a dangerous complication not to be underestimated.
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7/24. Incomplete duplication of the esophagus: a case report.

    A case of incomplete duplication of the esophagus diagnosed in a 20-month-old girl with an esophageal perforation is presented. X-ray films of the chest showed pneumomediastinum and subcutaneous emphysema. A water soluble contrast esophagogram revealed a contrast leakage from the cervical esophagus to the thoracic inlet. The endoscopic findings are described. Complete resection of the esophageal duplication was effective.
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8/24. Spontaneous pneumomediastinum in a scuba diver.

    Pneumomediastinum usually occurs following an airleak from the lungs, or from a perforated oesophagus. We report on a 30-year-old man who developed pneumomediastinum after scuba diving. The patient presented with acute onset of throat pain, odynophagia, and hoarseness of voice. The literature is reviewed for this condition.
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9/24. Perforation of the esophagus caused by the insertion of an intragastric balloon for the treatment of obesity.

    obesity is an enduring chronic disease, with multifactorial etiology. Many procedures and solutions have been proposed in the last 25 years. If patients do not meet the criteria for bariatric surgery, intragastric balloons may be used to achieve weight reduction. Contraindications to balloon therapy are a large hiatal hernia, severe esophagitis, peptic ulceration and previous gastric surgery. Although intragastric balloons are advocated as safe devices, major complications such as intestinal obstruction, gastric perforation and gastric ulceration have been described. We report a case of esophageal rupture due to insertion of an intragastric balloon for the treatment of morbid obesity, for which no contraindication existed. When abnormal pain or discomfort arises, or esophageal damage is noted after insertion of an intragastric balloon, patients must be closely monitored to diagnose a possible esophageal rupture early and thereby prevent severe complications.
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10/24. Esophageal intramural pseudodiverticulosis complicated by pneumomediastinum.

    We report a rare case of esophageal intramural pseudodiverticulosis with perforation of the esophagus. A 32-year-old male presented with acute thoracal pain after a period of vomiting. Computed tomography revealed an important amount of mediastinal free air and small outpouchings in the wall of the esophagus. During the following thoracic surgery procedure no macroscopic site of rupture could be identified. Pseudodiverticulosis was detected during a barium swallow exam of the esophagus 4 weeks later.
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