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PubMed2004

Measurement of health-related quality of life in the national emphysema treatment trial.

PURPOSES: To evaluate two generic and two disease-specific measures of health-related quality of life (QOL) using prerandomization data from the National Emphysema Treatment Trial (NETT). METHOD: The analyses used data collected from the 1,218 subjects who were randomized in the NETT. Patients completed evaluations before and after completion of the prerandomization phase of the NETT pulmonary rehabilitation program. Using data obtained prior to participation in the rehabilitation program, QOL measures were evaluated against physiologic and functional criteria using correlational analysis. The physiologic criteria included estimates of emphysema severity based on FEV(1) and measures of Pao(2) obtained with the subject at rest and breathing room air. Functional measures included the 6-min walk distance (6MWD), maximum work, and hospitalizations in the prior 3 months. RESULTS: Correlation coefficients between QOL measures ranged from -0.31 to 0.70. In comparison to normative samples, scores on general QOL measures were low, suggesting that the NETT participants were quite ill. All QOL measures were modestly but significantly correlated with FEV(1), maximum work, and 6MWD. Patients who had stayed overnight in a hospital in the prior 3 months reported lower QOL on average than those who had not been hospitalized. There were significant improvements for all QOL measures following the rehabilitation program, and improvements in QOL were correlated with improvements in 6MWD. COMMENT: The disease-specific and general QOL measures used in the NETT were correlated. Analyses suggested that these measures improved significantly following the rehabilitation phase of the NETT.

Activities of Daily Living↗
PubMed1991

Subcutaneous and mediastinal emphysema associated with hypersensitivity pneumonitis.

We report a rare case of a patient in whom severe subcutaneous and mediastinal emphysema occurred in association with summer-type hypersensitivity pneumonitis and in whom overdistention or disruption of alveoli with obliteration of the respiratory bronchioles was revealed on open lung biopsy. This case suggests that obstructive bronchiolitis with hypersensitivity pneumonitis is an etiologic factor of mediastinal emphysema.

Adult↗
PubMed1990

Orbital emphysema causing vision loss after a dental extraction.

The use of high-speed air-cooled rotary cutting instruments is common in dental practices. When used near open wounds, the forced air can lead to subcutaneous emphysema and involvement of vital structures. This case highlights the unfortunate episode of orbital emphysema with optic nerve damage after a pneumatically cooled drill was used in the removal of a mandibular second molar.

Adult↗
PubMed1990

Pneumomediastinum and subcutaneous emphysema during laparoscopy.

Laparoscopy, with the use of carbon dioxide or nitrous oxide for insufflation is a common procedure with the potential for several major complications. For example, pneumomediastinum, pneumothorax, and subcutaneous emphysema can occur singly or in any combination with this procedure. The authors report a patient in whom pneumomediastinum and massive subcutaneous emphysema developed without pneumothorax. Possible mechanisms are presented, along with discussion of the need for prompt diagnosis and termination of the procedure with deflation of the abdomen. The life-threatening potential of this complication is emphasized.

Adult↗
PubMed1990

Subcutaneous emphysema of the lower extremity. A case report.

The case presented is a rare example of subcutaneous emphysema isolated to an extremity. This is a benign condition and should not be confused with necrotizing gas-producing infections. In most cases, the condition rapidly resolves without treatment, usually in less than 48 hr. In rare cases where the mechanical process causing the subcutaneous emphysema persists, interruption of this process is required.

Aged↗
PubMed2000

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.

Anesthesia, General↗
PubMed2000

Bilateral pneumothorax with extensive subcutaneous emphysema manifested during third molar surgery. A case report.

This report describes a case of bilateral pneumothorax with extensive subcutaneous emphysema in a 45-year-old man that occurred during surgery to extract the left lower third molar, performed with the use of an air turbine dental handpiece. Computed tomographic scanning showed severe subcutaneous emphysema extending bilaterally from the cervicofacial region and the deep anatomic spaces (including the pterygomandibular, parapharyngeal, retropharyngeal, and deep temporal spaces) to the anterior wall of the chest. Furthermore, bilateral pneumothorax and pneumomediastinum were present. In our patient, air dissection was probably caused by pressurized air being forced through the operating site into the surrounding connective tissue.

Humans↗
PubMed2003

Cervical emphysema secondary to pneumomediastinum as a complication of childbirth.

Pneumomediastinum and cervical emphysema usually occur following esophageal or chest trauma. Rarely do they occur as a complication of childbirth, and only approximately 200 such cases have been reported in the literature worldwide. We describe a new case, and we review the clinical picture, pathophysiology, and management of these conditions. In view of the head and neck symptoms of pneumomediastinum and cervical emphysema during labor--which include dyspnea, cough, sore throat, pain on swallowing, and dysphagia--otolaryngologists might be consulted and should therefore be aware of these conditions in order to recognize and treat them.

Adult↗
PubMed2003

[Subcutaneous emphysema and pneumomediastinum after dental drilling].

Subcutaneous emphysema and pneumomediastinum is a rare complication of dental treatment. Our case report describes a case secondary to dental drilling with a high-speed air drill, and diffusion of the compressed air. Our case had the classical clinical features of sudden subcutaneous emphysema starting in the face, and subsequently extending into the neck and thorax, accompanied by severe pain and dyspnoea. Rapid medical treatment for this emergency avoided the surgical decompression.

Adult↗
PubMed1992

[Mediastinal and subcutaneous emphysema in connection with a normal labor].

A case of mediastinal and subcutaneous emphysema associated with a normal labour is presented and the literature is reviewed. Mediastinal and subcutaneous emphysema is a rare but potentially benign complication of normal labour, frequently observed in healthy young primiparae. Treatment should be directed towards exclusion of serious underlying disease. In mild cases, observation may be sufficient. Antibiotics are not considered necessary as a routine. If the complication is detected during labour, the delivery should be terminated with as little distress as possible for the mother employing forceps/vacuum extraction with a large episiotomy.

Adult↗
PubMedDate not supplied

Subcutaneous cervicofacial emphysema and pneumo-mediastinum: a rare complication after a crown preparation.

Subcutaneous cervicofacial emphysema and pneumo-mediastinum are relatively rare complications from different dental procedures (including oral surgery and restorative treatment). Many cases go unrecognized or are misdiagnosed. While the majority of cases resolve spontaneously, some can lead to life-threatening complications that require emergency intervention. This article presents a case report of subcutaneous and mediastinal emphysema following a routine restorative dental procedure. The differential diagnosis and management of this condition is discussed.

Adult↗
PubMed2005

Subcutaneous emphysema associated with pneumomediastinum after general anesthesia--closed rhinolalia as an initial presentation in one of two cases.

We report two cases of subcutaneous emphysema associated with pneumomediastinum after general anesthesia. One of them was devoid of common symptoms such as chest pain and dyspnea, but significant closed rhinolalia was noted initially. Though in these two cases the chest CT scanning revealed no perivascular emphysema, we highly suspected that this phenomanum resulted from alveolar rupture with Macklin effect. Close observation was the best treatment since neither trachea injury was in evidence nor was there the occurrence of other complication. The differential diagnosis and approach to therapy are presented after review of the relevant literature.

Adult↗
PubMed2006

Pneumomediastinum and subcutaneous emphysema associated with asthma exacerbation.

The case of a nineteen year old male student who presented with marked dyspnoea, dysphagia and horseness of voice is presented. Chest examination revealed bilateral polyphonic rhonchi and the chest radiograph showed the presence of subcutaneous emphysema and pneumomediastinum. A diagnosis of acute severe asthma complicated with subcutaneous emphysema and pneumomediastinum was made and the patient was managed conservatively on nebulized salbutamol, steroids, oxygen and chest physiotheraphy. He made a remarkable improvement and has remained in a stable clinical condition.

Adult↗
PubMedDate not supplied

Cervicofacial and mediastinal emphysema complicating a dental procedure.

Cervicofacial subcutaneous emphysema is an infrequently reported sequela of dental surgery. It may be caused by the inadvertent introduction of air into the soft tissues during procedures using high-speed, air-driven handpieces or air-water syringes. In this paper, we present a case in which subcutaneous emphysema developed in a middle-aged woman following routine restorative treatment. We review the features of the condition and its treatment and discuss means of prevention.

Adult↗
PubMed1990

[Subcutaneous emphysema as the initial manifestation of perforation of a hollow abdominal viscus].

The authors reports a case of cervical and abdominal subcutaneous emphysema, associated to pneumoretroperitoneum and pneumomediastinum, with no free air in the abdominal cavity, secondary to perforated diverticulitis of the sigmoid colon. We comment the rarity of this clinical presentation, the physiopathologic mechanisms of subcutaneous air presence in cases of non instrumental perforation of abdominal viscera and the ominous significance of the subcutaneous emphysema in such perforations.

Aged↗
PubMed1990

[Post-traumatic subcutaneous emphysema--misdiagnosed as gas gangrene].

Two cases of subcutaneous emphysema which developed after minor trauma are presented. One patient had a wound on the tip of the olecranon, and the other an interdigital wound. Both cases were misdiagnosed as gas gangrene, and treated with surgical revision and antibiotics. Neither necrosis nor bacteria were found. Both cases of emphysema were believed to be due to the pumping effect of the movement of the limbs.

Aged↗