Spot the Pneumothorax.

acute medical emergencies management chest drain secondary pneumothorax subcutaneous drain surgical emphysema

Journal

Cureus
ISSN: 2168-8184
Titre abrégé: Cureus
Pays: United States
ID NLM: 101596737

Informations de publication

Date de publication:
Aug 2021
Historique:
accepted: 14 08 2021
entrez: 22 9 2021
pubmed: 23 9 2021
medline: 23 9 2021
Statut: epublish

Résumé

Subcutaneous emphysema (SE) and pneumomediastinum are commonly associated with critically ill patients with blunt or penetrating trauma, in particular lower rib fractures. It however rarely needs urgent intervention, and routine use of chest tube tracheostomy or mediastinal drains is not recommended as the patients do not go on to develop a respiratory compromise. Our case is novel as it describes a case of subcutaneous emphysema with acute upper airway compromise and respiratory distress requiring urgent bilateral wide bore subcutaneous drains and thoracic drain insertion. The patient required a prolonged recovery period. This case serves to illustrate the technical difficulty in establishing a cause of subcutaneous emphysema, the limitations of standard imaging in identifying a pneumothorax in subcutaneous emphysema, and the value of prompt insertion of bilateral subcutaneous wide bore drains to buy precious time for definitive imaging and management.

Identifiants

pubmed: 34548979
doi: 10.7759/cureus.17177
pmc: PMC8437209
doi:

Types de publication

Case Reports

Langues

eng

Pagination

e17177

Informations de copyright

Copyright © 2021, Harridine et al.

Déclaration de conflit d'intérêts

The authors have declared that no competing interests exist.

Références

Thorax. 1988 Jul;43(7):576-7
pubmed: 3212757
Chest. 1993 Jan;103(1):323
pubmed: 7678081
Anaesthesia. 1995 Dec;50(12):1077-9
pubmed: 8546291
Int J Surg Case Rep. 2018;44:126-130
pubmed: 29501016
Interact Cardiovasc Thorac Surg. 2014 Dec;19(6):904-7
pubmed: 25164135
Chest. 1992 Aug;102(2):503-5
pubmed: 1340766
J Surg Case Rep. 2018 Jul 19;2018(7):rjy173
pubmed: 30046438
Tex Heart Inst J. 1999;26(2):129-31
pubmed: 10397436
Indian J Surg. 2015 Dec;77(Suppl 2):673-7
pubmed: 26730086

Auteurs

Joshua Harridine (J)

Acute Respiratory Care Unit, Nottingham University Hospital, Nottingham, GBR.

Milind Sovani (M)

Respiratory Medicine, Nottingham University Hospital, Nottingham, GBR.

Classifications MeSH