[Pneumothorax, mediastinal emphysema and spontaneous subcutaneous emphysema in asthmatics].
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Asthma↗
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Results for “Subcutaneous Emphysema”
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What is your diagnosis? Pulmonary bullous emphysema with pneumothorax and subcutaneous emphysema.
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Animals↗
Subcutaneous emphysema and pneumomediastinum complicating tonsillectomy.
BACKGROUND: Subcutaneous emphysema and pneumomediastinum are very rare complications of tonsillectomy. OBJECTIVES: To report on a case study and a literature review of these conditions; to discuss the management and controversial causes. DESIGN: Case study and literature review. METHODS: A case is presented of subcutaneous emphysema and pneumomediastinum complicating tonsillectomy. All published reports of these complications dating back to 1910 are reviewed. RESULTS: An additional 30 cases of subcutaneous emphysema and 9 of pneumomediastinum have been reported following tonsillectomy. This group of 32 patients with emphysematous complications included 17 male patients, 14 female, and a child of unknown sex. The mean age was 18.6 years (range, 2-65 years). All tonsillectomies were performed with a cold technique except our case. Subcutaneous emphysema was first noted intraoperatively in 8 patients (25%) a mean of 3.5 hours (range, 10 minutes to 14 hours) after the procedure in 18 patients (56%) and not until the next morning in 6 patients (19%). Most cases resolved without specific treatment or significant sequelae. Some cases were life-threatening and required urgent intervention. Others were misdiagnosed, which resulted in unnecessary surgery. CONCLUSION: Subcutaneous emphysema and pneumomediastinum are rare occurrences following tonsillectomy that should alert one to the possibility of more serious complications.
Adult↗
Subcutaneous emphysema associated with chest tube drainage.
BACKGROUND: Subcutaneous emphysema may complicate a pneumothorax, but may also occur as a consequence of its treatment by chest tube drainage. The aim of this study was to evaluate the factors involved in the association between subcutaneous emphysema and chest tube drainage, and the clinical outcomes in these cases. METHODOLOGY: One hundred and sixty-seven patients undergoing chest tube drainage within a 12-month period were evaluated retrospectively. There were 30 reported cases of subcutaneous emphysema (SE). Comparisons were made between those with subcutaneous emphysema and those who did not develop this complication. RESULTS: A total of 134 patient notes were evaluated (25 SE and 109 non-SE). Subcutaneous emphysema was more commonly associated with trauma, bronchopleural fistulae, large and bilateral pneumothoraces, and mechanical ventilation. Subcutaneous emphysema was also associated with prolonged drainage, poor tube placement, tube blockage, side-port migration, and a greater number of chest tubes. Importantly, those with SE had a longer length of stay and increased mortality. CONCLUSION: Subcutaneous emphysema can be spontaneous or traumatic, but is associated with avoidable causes such as inadequate chest tube drainage, particularly due to poor tube placement, anchorage and blockage, and also with side-port migration into the subcutaneous tissue. It is associated with an increased morbidity and mortality, and may indicate the need for urgent chest tube replacement.
Adolescent↗
[A case of mediastinal emphysema with bilateral pneumothorax and subcutaneous emphysema of the neck].
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Child↗
Subcutaneous emphysema during labour.
Subcutaneous emphysema is an unusual but potentially dangerous complication of pregnancy and labour. The incidence is unknown. About 200 cases have been reported in world literature, mainly in primiparous women. This report describes a 30-year-old primigravid who complained during labour of a sudden swelling in her face associated with a mild difficulty in breathing.
Journal Article↗
Massive subcutaneous emphysema following percutaneous tracheostomy.
BACKGROUND: Bronchoscopic subcutaneous dilatational tracheostomy is fast becoming the method of choice for securing an airway in chronic ventilated patients in an intensive care setting. Many studies have demonstrated that it is a cost-effective and safe procedure in experienced hands. Complications appear to be equivalent to those encountered in open tracheostomy. Subcutaneous emphysema following tracheostomy is a rare occurrence. Only 3 cases have been described following percutaneous dilatational tracheostomy. Management can be quite complex. MATERIAL AND METHODS: Retrospective review with case report of a patient with massive subcutaneous emphysema following percutaneous tracheostomy. CONCLUSION: Massive subcutaneous emphysema following percutaneous tracheostomy is a major complication that is rarely encountered. When due to a posterior tracheal wall tear, management consists of bypassing the laceration and allowing it to heal secondarily.
Aged↗
[Nontraumatic subcutaneous emphysema. Diagnostic and therapeutic problems].
Nontraumatic subcutaneous emphysema is less frequent than traumatic. Its occurrence, unless synchronous with the treatment of spontaneous pneumothorax, usually is the consequence of exacerbation of COPD or of the obstruction of major bronchi. However, in routine clinical practice, the occurrence of subcutaneous emphysema without evident underlying disease, in combination with normal chest x-ray, still is a diagnostic and therapeutic problem. In this study typical mechanisms of this phenomenon are presented; air-trapping at the level of the main bronchus caused by endobronchial tumour growth, progressive destruction of alveoles by diffuse lung disease irrespective of its nature, and mechanism of its occurrence during dealing with the urgent clinical problem in the intensive care unit. This study does not deal with subcutaneous emphysema during the attack of severe asthma assuming it as well known situation that usually does not cause a major therapeutic problem. The sequence of necessary diagnostic and therapeutic steps is discussed taking account of possible pitfalls that usually exist in all of three described pathophysiological situations.
Humans↗
Subcutaneous emphysema in advanced cancer.
Spontaneous subcutaneous emphysema is a rare and usually benign entity that may occasionally be symptomatic. We report a case of a patient with advanced cancer who developed extensive but asymptomatic subcutaneous emphysema shortly before death. Perforation of the lower gastrointestinal tract, perhaps as a result of straining due to severe unrelieved constipation or due to fistula formation, is suspected to have been the mechanism. The causes, treatment, and implications for management of this condition are discussed.
Adenocarcinoma↗
Spontaneous pneumomediastinum and subcutaneous emphysema.
Spontaneous pneumomediastinum with subcutaneous emphysema is a well-documented phenomenon which usually follows a benign course and rarely results in circulatory collapse and death. The condition is caused by a sustained increase in the intra-alveolar and intrabronchial pressure with air dissecting along the perivascular spaces of the mediastinum. The majority of patients respond to conservative therapy and rarely require aggressive surgical intervention. Three cases are presented. The anatomy, etiology and the pathophysiology of the disease are reviewed, and the treatment options discussed.
Adolescent↗
Postpartum subcutaneous emphysema with pneumomediastinum.
Spontaneous subcutaneous emphysema with pneumomediastinum occurs rarely in the setting of labour and delivery. We report the following occurrence in a 17 year old woman following delivery. Signs, symptoms, and pathophysiology are reviewed and treatment is discussed.
Female↗
Subcutaneous emphysema and mediastinitis: unusual complications of tonsillectomy.
INTRODUCTION: Subcutaneous emphysema and mediastinitis are rarely reported complications of tonsillectomy. CASE REPORT: We describe two patients who developed subcutaneous emphysema, one of them with mediastinitis, within a few days after tonsillectomy. The diagnosis was based on the clinical presentation and confirmed by computed tomography (CT). For the patient without mediastinitis, the emphysema disappeared after a short period of reintubation and administration of antibiotics. For the patient with mediastinitis, surgical drainage of a cervico-mediastinal purulent collection was necessary to obtain healing. DISCUSSION: The events leading to subcutaneous emphysema and mediastinitis have not been entirely clarified. They probably include direct introduction of air into the neck via either the tonsillar bed or a laryngeal or pharyngeal wound caused by intubation. The clinical presentation, treatment and possible pathophysiology of subcutaneous emphysema and medisastinits are discussed. CONCLUSION: Emphysema and mediastinitis after tonsillectomy occur seldomly. If rapidly recognised and appropriately managed, mortality can be avoided.
Adult↗
Subcutaneous emphysema after dental treatment: a case report.
Subcutaneous emphysema is the condition in which air or other gases penetrate the skin and submucosa causing soft-tissue distention. This type of emphysema may be traumatic, iatrogenic or may occur spontaneously. This report describes the youngest case of subcutaneous emphysema related to dental treatment that has been documented to date. In addition to the patient's age, the case is of interest because subcutaneous emphysema is a rare complication of dental therapy.
Anesthesia, Dental↗
[Developing subcutaneous emphysema after dental care].
Subcutaneous emphysema is a rare but potentially dangerous complication of dental and maxillofacial surgical interventions. The authors present three such cases and give an overview on the diagnostic, therapeutic and preventive possibilities of the disease.
Adult↗
Implications, prevention and management of subcutaneous emphysema during endodontic treatment.
Subcutaneous emphysema (SCE) is a possible complication of both nonsurgical and surgical endodontic treatment. A review of the literature pertinent to endodontic intervention and SCE is highlighted, while the causes of and recommendations for the prevention of SCE are provided. A review of the pathways whereby compressed air may travel through potential spaces in the head and neck is also illustrated in an attempt to identify the possibility of morbidity and even mortality should operator induced SCE occur in a patient.
Humans↗
Botulinum toxin as treatment for a unique case of subcutaneous emphysema.
A developmentally delayed 11-year-old male developed extensive spontaneous subcutaneous emphysema 6 weeks after a laryngotracheal separation. Computed tomography demonstrated a small amount of air at the distal end of the laryngeal stump and significant esophageal air. Aerophagia was diagnosed with air presumed diverted through the laryngeal stump due to cricopharyngeal hypertension. Cricopharyngeal botulinum toxin injection was coordinated with a minimal neck dissection to drain the subcutaneous emphysema. The subcutaneous emphysema gradually improved and the patient was discharged home. His subcutaneous emphysema has not returned after four total botulinum toxin injections every 3 months.
Aerophagy↗
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.
Adult↗
Subcutaneous emphysema.
A medical emergency, the detection of subcutaneous emphysema requires thorough evaluation to exclude the multitude of disease processes that may demonstrate this clinical finding. Gas gangrene must be considered in the differential diagnosis of all forms of subcutaneous emphysema and infections with some species, such as C. novyi, may not produce gas at all. Isolation of C. septicum from the blood is almost always associated with colon cancer or hematologic malignancies. Nonclostridial gas gangrene in diabetic patients is indistinguishable clinically from clostridial gas gangrene. A unique and true dermatologic emergency is the detection of nontraumatic subcutaneous emphysema of the thigh with or without associated erythema, tenderness, or bullous lesions. This finding is associated with perforated viscus in a retroperitoneal location. Infections with gas-producing organisms continue to be a source of significant morbidity in modern times.
Animals↗