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Spontaneous pneumomediastinum with subcutaneous emphysema in a young healthy female, a case report.

ABSTRACT: The terms "free air or gas located within the mediastinum and subcutaneous tissue that are not associated with any obvious causes, such as chest trauma," are used to characterise spontaneous pneumomediastinum (SPM) and subcutaneous emphysema (SE). SPM has been linked to a variety of illnesses and causes, including bronchial asthma, diabetic ketoacidosis, strenuous exercise, strenuous coughing, medication intake, and other actions involving the Valsalva maneuver. We describe a case of spontaneous cervical, retropharyngeal, and mediastinal emphysema in a young female who was previously healthy. She was brought into the ward for observation, vital sign monitoring, analgesics, and prophylactic antibiotics. She started taking analgesics, preventative antibiotics, and 100% oxygen throughout that period to help with absorption. The neck pain gradually subsided, and there were no bouts of oxygen desaturation or abnormal vital signs. After subsequently getting better, the patient went home. The patient was examined in an outpatient clinic two weeks after being discharged and shown no signs of illness. To sum up, subcutaneous emphysema and pneumomediastinum are uncommon presentations seen in the emergency room, but they are typically self-limiting.

SUBMITTER: Molla YD

PROVIDER: S-EPMC10372730 | biostudies-literature | 2023 Jul

REPOSITORIES: biostudies-literature

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Spontaneous pneumomediastinum with subcutaneous emphysema in a young healthy female, a case report.

Molla Yohannis Derbew YD Abegaz Sead Hassen SH Desita Zerubabel Tegegne ZT

Heliyon 20230715 7

The terms "free air or gas located within the mediastinum and subcutaneous tissue that are not associated with any obvious causes, such as chest trauma," are used to characterise spontaneous pneumomediastinum (SPM) and subcutaneous emphysema (SE). SPM has been linked to a variety of illnesses and causes, including bronchial asthma, diabetic ketoacidosis, strenuous exercise, strenuous coughing, medication intake, and other actions involving the Valsalva maneuver. We describe a case of spontaneous ...[more]

PMID: 37519660

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Project description:ImportanceManagement of severe coronavirus disease 2019 relies on advanced respiratory support modalities including invasive mechanical ventilation, continuous positive airway pressure, and noninvasive ventilation, all of which are associated with the development of subcutaneous emphysema, pneumomediastinum, and pneumothorax (herein collectively termed barotrauma).ObjectivesTo assess the occurrence rate of barotrauma in severe coronavirus disease 2019 and to explore possible associated factors.Design setting and participantsA retrospective, single-center cohort study with nested case series, conducted at University Hospital Lewisham: a 450-bed general hospital in London, United Kingdom. All patients with confirmed coronavirus disease 2019 admitted to the critical care department from March 12, to April 12, 2020, were included.Main outcomes and measuresPatients were retrospectively screened for radiological evidence of barotrauma. Admission characteristics, modalities of respiratory support, and outcomes were compared between barotrauma and nonbarotrauma groups. Respiratory parameters in the period preceding barotrauma identification were recorded.ResultsOf 83 admissions with coronavirus disease 2019, eight suffered barotrauma (occurrence rate 9.6%; 95% CI 4.3%-18.1%). Barotrauma cases had longer illness duration prior to critical care admission (10 vs 7 d; interquartile range, 8-14 and 6-10, respectively; p = 0.073) and were more often treated with continuous positive airway pressure or noninvasive ventilation as the initial modality of advanced respiratory support (87.5% vs 36.0%; p = 0.007). Patients managed with continuous positive airway pressure or noninvasive ventilation prior to the development of barotrauma had median minute ventilation of 16.2-19.9 and 21.3-22.7 L/min, respectively. Compared with the nonbarotrauma group, a higher proportion of patients with barotrauma had died (62.5% vs 43.2%), and a lower proportion of patients had been discharged (25.0% vs 53.3%) at 3-month follow-up.Conclusions and relevanceBarotrauma appears to be a common complication of severe coronavirus disease 2019. Determining whether high minute ventilation while using continuous positive airway pressure or noninvasive ventilation predisposes patients to barotrauma requires further investigation.

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Spontaneous pneumomediastinum with subcutaneous emphysema in a young healthy female, a case report.

Publications

Spontaneous pneumomediastinum with subcutaneous emphysema in a young healthy female, a case report.

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