Subcutaneous Emphysema, Pneumomediastinum and Spinal Epidural Emphysema As Complications of Violent Coughing: A Case Report Spontaneous pneumomediastinum

Main Article Content

Fevzi Yılmaz
Ökkeş Zortuk https://orcid.org/0000-0001-6776-2702

Keywords

Pneumomediastinum, Subcutaneous Emphysema, Emergency

Abstract

Spontaneous pneumomediastinum (SPM) is a rare condition characterized by chest pain of sudden­ onset, difficulty breathing, dysphagia, dysphonia, and subcutaneous emphysema, which are some-times ­accompanied by pain in the neck or back. This condition typically has a benign character that limits itself, and supportive therapy is all that is needed; however, life-threatening consequences may occur, such as upper respiratory tract obstruction, esophageal injury, and tracheal damage, requiring surgery. We report here a man aged 19 years who coughed vigorously due to acute allergic asthma, which lead to subcutaneous emphysema starting from the neck down to the chest, mediastinum and spinal epidural space. This case report stresses the importance of including SPM in the differential diagnosis of cough and chest pain in the young.


 

Abstract 366 | PDF Downloads 146

References

References
1. Mason R, Broaddus V.C, Martin T. Pneumomediastinum and mediastinitis, in Murray and Nadel's Textbook of Respiratory Medicine, 5th Edition, 2010, Elsevier Health Sciences.
2. Fitzwater JW, Silva NN, Knight CG, Malvezzi L, Ramos-Irizarry C, Burnweit CA. Management of spontaneous pneumomediastinum in children. J Pediatr Surg 2015; 50 (6): 983-6.
3. Song IH, Lee SY, Lee SJ, Choi WS. Diagnosis and treatment of spontaneous pneumomediastinum: experience at a single institution for 10 years. Gen Thorac Cardiovasc Surg 2017; 65(5): 280-4.
4. Paul N, Vasudev R, Nanavati S, et al. Spontaneous pneumomediastinum complicated by pneumopericardium after a single use of inhaled methamphetamine. Lung India 2019; 36(3): 271-3.
5. Chu CM, Leung YY, Hui JY, et al. Spontaneous pneumomediastinum in patients with severe acute respiratory syndrome. Eur Respir J 2004; 23(6): 802-4.
6. Maravelli AJ, Skiendzielewski JJ, Snover W. Pneumomediastinum acquired by glass blowing. J Emerg Med 2000; 19(2): 145-7.
7. Özhasenekler A, Gökhan Ş, Yılmaz F, Tan Ö, Nasır A. Pneumomediastinum and Pneumothorax After Blunt Neck Trauma. Journal of Emergency Medicine Case Reports 2010; 1(2): 17-9.
8. Girard C, Khouatra C, Cordier JF, Cottin V. Spontaneous pneumomediastinum associated with pneumorachis. Am J Respir Crit Care Med 2014; 189(11): e69.
9. Murayama S, Gibo S. Spontaneous pneumomediastinum and Macklin effect: Overview and appearance on computed tomography. World J Radiol 2014; 6(11): 850-4.
10. Carolan PL, Wright SL, Jha V. Spontaneous pneumorrhachis. Pediatr Emerg Care 2013; 29(4): 508-9.
11. Raley JC, Andrews JI. Spontaneous pneumomediastinum presenting as jaw pain during labor. Obstet Gynecol 2001; 98(5): 904-6.
12. Vianello A, Caminati M, Chieco-Bianchi F, et al. Spontaneous pneumomediastinum complicating severe acute asthma exacerbation in adult patients. J Asthma 2018; 55(9): 1028-34.
13. Chiba Y, Kakuta H. Massive subcutaneous emphysema, pneumomediastinum, and spinal epidural emphysema as complications of violent coughing: a case report. Auris Nasus Larynx. 1995; 22(3): 205-8.