Cases reported "Mediastinal Emphysema"

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1/75. Pneumomediastinum as a complication of extraperitoneal laparoscopic inguinal hernia repair.

    A 52-year-old man with left indirect groin hernia was admitted for elective inguinal repair using the totally extraperitoneal (TEP) approach. After an uneventful intubation, TEP repair of the hernia was performed with three midline trocars. Immediately after extubation, the patient noted severe chest pain. There was a decrease in PaO2 saturation, and neck subcutaneous emphysema was detected. There was no emphysema of the abdomen or of the back. A chest film and thoracic computed tomographic (CT) scan confirmed the presence of pneumomediastinum without pneumothorax. The patient was discharged without complications.
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keywords = neck
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2/75. subcutaneous emphysema and pneumomediastinum after dental extraction.

    Pneumomediastinum, pneumothorax, and subcutaneous emphysema can occur occasionally after a surgical procedure. Facial swelling is a common complication of dental management. The occurrence of subcutaneous emphysema, pneumothorax, and pneumomediastinum after dental procedures is rare. We present a case with subcutaneous emphysema of the upper chest, neck, chin, and pneumomediastinum after a tooth extraction and discuss the possible mechanism of subcutaneous emphysema. To prevent these complications during dental procedures, dental hand pieces that have air coolant and turbines that exhaust air in the surgical field should not be used.
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3/75. Surgical emphysema and pneumomediastinum in a child following minor blunt injury to the neck.

    Largyngotracheal and pharyngoesophageal tears following minor blunt trauma to the neck are uncommon. A child with such an injury is reported and the modes of diagnosis and management are discussed. patients may initially present with minimal signs and symptoms, but their condition may deteriorate rapidly or insidiously. In the absence of respiratory compromise, conservative management is appropriate, but all patients with significant blunt neck trauma should undergo early direct laryngoscopy under a general anaesthetic.
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keywords = neck
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4/75. Pneumomediastinum due to Venturi jet ventilation used during microlaryngeal surgery in a previously neck-irradiated patient.

    Serious complications secondary to Venturi jet ventilation used during microlaryngoscopy are rare, but when they occur, they may pose a life-threatening emergency. We report the case of a 45-year-old woman, previously treated with 70 Gy of irradiation for a T1 laryngeal carcinoma, who developed pneumomediastinum and subcutaneous emphysema after the use of Venturi jet ventilation. Keeping in mind the histologic changes to the irradiated structures, we suggest more caution when using Venturi jet ventilation in patients who have recently undergone neck irradiation therapy.
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keywords = neck
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5/75. Traumatic pneumomediastinum caused by isolated blunt facial trauma: a case report.

    Traumatic pneumomediastinum is most often identified as an incidental finding in the setting of blunt or penetrating neck, chest, or abdominal trauma. There are only a few cases in the medical literature of a pneumomediastinum following isolated facial trauma. We present a patient who sustained fractures of the lateral and anterior walls of the right maxillary sinus, floor of the right orbit, and right zygomatic arch. subcutaneous emphysema overlaid the right facial region and extended to the left side of the neck and into the mediastinum. We describe this unusual complication with respect to the anatomic relations of the facial and cervical fascial planes and spaces with the mediastinum.
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keywords = neck
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6/75. subcutaneous emphysema and pneumomediastinum after endotracheal anaesthesia.

    INTRODUCTION: We report a case of subcutaneous emphysema and pneumomediastinum that presented postoperatively after tracheal extubation. CLINICAL PICTURE: A 51-year-old man had an uneventful anaesthesia lasting about 6.5 hours. intubation was performed by a very junior medical officer and was considered difficult. He developed sore throat, chest pain, numbness of both hands and palpable crepitus around the neck postoperatively. Chest X-ray revealed diffuse subcutaneous emphysema, pneumomediastinum and possible pneumopericardium. TREATMENT: He was treated conservatively with bed rest, oxygen, analgesia, antibiotic prophylaxis, reassurance and close monitoring. OUTCOME: The patient made an uneventful recovery. CONCLUSIONS: We discussed the possible causes.
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keywords = neck
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7/75. Pneumomediastinum and pneumopericardium: unusual and rare complications of asthma in a 4 years old girl.

    We describe a 4-year-old girl with asthma who presented with pneumomediastinum, pneumopericardium and subcutaneous emphysema. She was admitted to our hospital with dyspnea, chest pain, palpitation and cough of two days duration. She had attacks of cough, dyspnea and wheezing from two years of age, but she did not have a diagnosis of asthma previously. She was dyspneic and had subcutaneous emphysema in the neck, axilla and thorax. In the skin prick test (Center Lab. USA) she had positive reaction to dermatophagoides pteronyssinus, dermatophagoides farinae, mold mix, tree mix and grass mix. Pulmonary function tests could not be performed. In the chest X-ray air was seen in mediastinum and subcutaneous area and the epicardium was surrounded completely with air. She was treated successfully with inhaled salbutamol and budesonide. Radiological signs of pneumopericardium and pneumomediastinum disappeared completely in ten days period. In the light of this case we want to mention that early diagnosis and treatment of asthma should be done to prevent serious complication of asthma.
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keywords = neck
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8/75. 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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keywords = neck
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9/75. Spontaneous pneumomediastinum, pneumothorax and ecstasy abuse.

    A case report is presented of a patient with bilateral pneumothoraces and spontaneous pneumomediastinum associated with ecstasy use. pneumothorax and spontaneous pneumomediastinum should be considered in an ecstasy user who complains of chest pain, neck pain or shortness of breath.
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keywords = neck
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10/75. Persistent pneumomediastinum and dermatomyositis: a case report and review of the literature.

    We describe a 42-year-old man with dermatomyositis and interstitial lung disease who presented with anterior neck pain and dyspnoea. Chest radiographs showed subcutaneous emphysema, pneumomediastinum and diffuse reticulonodular infiltration in both lungs. After the administration of high doses of prednisolone, an improvement of pulmonary function and respiratory symptoms was observed but the pneumomediastinum persists 12 months after diagnosis, and without any complication. We review the cases that have been reported thus far of pneumomediastinum associated with dermatomyositis and discuss the possible mechanisms involved. We conclude that pneumomediastinum is not an uncommon complication of dermatomyositis and that its aetiopathogenesis remains very unclear.
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keywords = neck
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