Images in Clinical Medicine
Pneumomediastinum and Severe Subcutaneous Emphysema
N Engl J Med 2000; 342:1333May 4, 2000
- Article
Figure 1 A 76-year-old man with chronic obstructive pulmonary disease was admitted after a car accident. The initial clinical and radiographic evaluation showed no evidence of rib fractures or other chest trauma. Several hours later, his neck and upper chest became increasingly swollen. Crepitations were detected on palpation of the swollen areas. Respiratory failure developed (respiratory rate, 36 per minute; pulse rate, 120 per minute; and blood pressure, 120/75 mm Hg). A chest x-ray film showed pneumomediastinum (open arrows) and extensive subcutaneous emphysema (solid arrow) that appeared in part as a cast of the muscles of the upper chest wall. Bronchoscopy and esophagogastroscopy detected no mucosal rupture of the inspected areas. The patient received assisted ventilation with limited peak airway pressures. After seven days, the subcutaneous crepitus had completely resolved and ventilatory support was discontinued. The patient's recovery was uneventful.
Frank G.H. van der Kleij, M.D.
Jan G. Zijlstra, M.D., Ph.D.
University Hospital Groningen, 9700 RB Groningen, the Netherlands- Citing Articles (1)
Citing Articles
1
Mark Sheldo Lloyd, Stas Jankowksi. (2009) Treatment of Life-Threatening Surgical Emphysema with Liposuction. Plastic and Reconstructive Surgery 123:2, 77e-78e
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