Subcutaneous Emphysema in Acute Asthma: A Cause for Concern? (original) (raw)
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Case Reports in Emergency Medicine, 2012
Simultaneous bilateral spontaneous pneumothorax (SBSP) and pneumomediastinum are complications rarely observed synchronously during an acute asthma attack. It is a clinical condition that manifests itself with serious respiratory distress and must be rapidly diagnosed and treated. Although bilateral spontaneous pneumothorax has already been reported in asthma patients in the literature, its concurrence with subcutaneous emphysema and pneumomediastinum is extremely rare except for iatrogenic conditions. By sharing this case about a 39-year-old patient who presented to the emergency room with severe respiratory distress and developed cardiopulmonary arrest during his physical examination, our aim is to emphasize that a rapid diagnosis and treatment by the emergency physicians is the only way for survival in these patients.
Spontaneous Pneumomediastinum a Rare Asthma Complication
Folia Medica
Asthma is the most common chronic respiratory disease worldwide and its prevalence is increasing. Acute asthma complications are often the reason for admission to emergency healthcare service. In our article we present a case of a rare asthma complication – spontaneous pneumomediastinum with a short review of its incidence, etiology, diagnosis and management. Spontaneus pneumothorax is important to differentiate with secondary pneumomediastinum as well as other conditions as cardiac diseases (acute coronary syndrome, pericarditis, cardiac tamponade, pneumopericardium), lung diseases (pneumothorax, pulmonary embolism, tracheobronchial tree rupture), musculoskeletal disorders, and diseases of the esophagus (rupture and perforation o the esophagus). A chest X-ray is often reliable for diagnosis of spontaneous pneumomediastinum and when inconclusive, can be followed by CT. The management is usually conservative with oxygen and analgesia. Surgery is required only in cases of tracheobronc...
Cureus
Subcutaneous emphysema (SE) is a phenomenon in which air occupies structures under the skin and soft tissues. Common sites for SE include the neck and chest wall, which can extend to other body regions. In this case report, we describe the development of extensive SE, pneumothorax, pneumomediastinum, and pneumoperitoneum in an elderly female following blunt trauma to her right flank. The etiology of SE is broad and includes blunt and penetrating traumas; surgical, infectious, spontaneous causes; or any condition that yields a gradient between intra-alveolar and perivascular interstitial pressures. The incidence of SE has been reported to be 1.4%, while that of spontaneous pneumothorax has been reported to be 0.8% in patients receiving a percutaneous tracheostomy. Conversely, the occurrence of SE, pneumothorax, pneumomediastinum, and pneumoperitoneum in the same patient is rare. The most common signs and symptoms of SE are neck swelling and chest pain. Involvement of the deeper tissues of the thoracic outlet, chest, and abdominal wall often manifests in severe life-threatening conditions. SE can be diagnosed by detecting edema and crepitus of the scalp, neck, thorax, abdomen, and other body regions. Radiograph imaging can confirm the presence of soft-tissue air entry. Extensive SE in the setting of pneumothorax is an unusual entity for which there is, as of now, no consensus in management. Methods of treatment include supportive care, placement of blow holes for evacuation of soft-tissue emphysema, and bilateral infraclavicular incisions. SE is a rare complication that can arise from several etiologies. At the same time, various methods for managing this phenomenon have been mentioned with varying successful outcomes.
Journal of thoracic disease, 2014
This review is focused on the relationship between asthma, pneumothorax and pneumomediastinum while presenting a number of case reports that include these conditions. The association between pneumothorax and asthma is not widely known. While asthma includes a common disorder and is prevalent worldwide, its morbidity and mortality is high when is associated with pneumothorax. Furthermore, the delayed diagnosis of pneumothorax while focusing on asthma includes the higher risk of coincidental pneumothorax in asthmatic patients. In addition, pneumomediastinum is considered benign and self-limiting condition that responds to conservative therapy. Although it is rare, the concurrence of pneumomediastinum with pneumothorax may prove fatal during a serious asthma attack. In conclusion, the symptoms of chest pain, dyspnea or focal chest findings when presented in asthmatic patients, must always create suspicion of pneumothorax or pneumomediastinum to the physician.
Asthma exacerbation complicated by pneumomediastinum: Case report
2024
Spontaneous pneumomediastinum is a rare entity that can complicate an asthma attack and can occur in young adults or adolescents. The abrupt onset of pneumomediastinum is usually associated with dyspnea, cough and chest pain. We report a case of severe asthma attack complicated by spontaneous pneumomediastinum in a 25-year-old female patient. Chest X-ray and CT scan confirmed the diagnosis. Progression was favorable within 6 days of treatment
Spontaneous Pneumomediastinum and Subcutaneous Emphysema: A Two Cases Reports
Scholars Journal of Medical Case Reports
Spontaneous pneumomediastinum (SPM) is an uncommon, mostly benign disorder that usually occurs in young adult males without any apparent pre-existing factor or disease. SPM responds extremely well to conservative treatment, without recurrence in the great majority of cases. We report two cases of SPM and pneumothorax in two young males following a forceful vomiting and a bout of sudden coughing with no underlying lung lesion.
Massive subcutaneous emphysema, pneumomediastinum, and pneumopericardium in children
Journal of Pediatric Surgery, 2010
Massive subcutaneous emphysema (SE), pneumomediastinum (PM), and pneumopericardium (PP) are rare conditions in the pediatric population. Air leak syndrome is a constellation of disorders that include SE, PM, PP, and pulmonary interstitial emphysema. In children, SE, PM, and PP are associated with obstructive airway disease most often in the case of asthma. Management may be conservative or involve invasive procedures that require surgical intervention. Here, we describe a case of massive SE, PM, and PP in a 10-year-old child after placement of a peripherally inserted central line and review the literature.
A case of spontaneous pneumomediastinum presented with subcutaneous emphysema only
International Journal of Medical Science and Public Health, 2016
Subcutaneous emphysema with spontaneous pneumomediastinum is a rare benign condition, which, if diagnosed early, can be managed conservatively. We present a case of young woman who showed subcutaneous emphysema without any precipitating factors was found to reveal spontaneous pneumomediastinum and treated conservatively with rest, analgesics, and oxygen therapy.
Caspian Journal of Pediatrics (CJP), 2020
Background: Pneumomediastinum (PM) is caused by alveolar rapture. If air leak persists, subcutaneous emphysema occurs. The PM and subcutaneous emphysema have various etiologies. Common causes are respiratory tract infections and asthma exacerbations. Rarely, the PM occurs secondary to foreign body aspiration, and the life-threatening complications will occur without proper treatment. Case report: we report a 2.5-year-old boy who was presented with cough, fever, neck swelling and respiratory distress to Amirkola Children's Hospital. On examination, he had subcutaneous emphysema (SCE) in neck and upper thorax. He had pneumomediastinum in radiography. The patient was treated with oxygen, antibiotic, and due to the suspicious history of foreign body aspiration he underwent bronchoscopy by which pieces of nuts removed from his right main bronchus. Conclusions: PM and SCE are rare presentations of foreign body aspiration and in such circumstances, the possibility of foreign body should be considered.
HYPERTENSIVE PNEUMOMEDIASTINUM ASSOCIATED WITH EXTENSIVE SUBCUTANEOUS EMPHYSEMA IN CHEST TRAUMA: CASE REPORT (Atena Editora), 2023
Pneumomediastinum is a condition characterized by the presence of air in the mediastinum, generally has a benign evolution, and is sometimes underdiagnosed. In the current study, the authors describe a case of traumatic pneumomediastinum, associated with extensive subcutaneous emphysema, with unfavorable evolution and rapid progression to respiratory failure, however treated with upper airway drainage, with a successful outcome, without the need for surgical procedures. more invasive and morbid.