3.Subcutaneous Emphysema Due to Perforation of the Stomach.
Kyu Chul WHANG ; Chang Suh KIM ; Yun KIM ; Tae Yun YOUN
Yonsei Medical Journal 1970;11(2):203-207
No abstract available.
Adolescent
;
Emphysema/etiology*
;
Face
;
Human
;
Male
;
Mediastinal Emphysema/etiology
;
Neck
;
Peptic Ulcer Perforation/complications*
;
Pneumoperitoneum/etiology
;
Stomach Ulcer/complications*
6.Pneumomediastinum Secondary to Foreign Body Aspiration: Clinical Features and Treatment Explorement in 39 Pediatric Patients.
Xiao-Jian YANG ; Jie ZHANG ; Ping CHU ; Yong-Li GUO ; Jun TAI ; Ya-Mei ZHANG ; Li-Xing TANG ; Xin NI ;
Chinese Medical Journal 2016;129(22):2691-2696
BACKGROUNDPneumomediastinum (PM) secondary to foreign body aspiration (FBA) is rare in children. Although it is mainly benign, some cases may be fatal. Due to the rare nature of this clinical entity, proper assessment and management have been poorly studied so far. Here, we characterized the presentation and management of this clinical entity and provided an evaluation system for the management.
METHODSWe retrospectively reviewed children with PM secondary to FBA, who were treated in Beijing Children's Hospital from January 2010 to December 2015. All patients were stratified according to the degree of dyspnea on admission, and interventions were given accordingly. Bronchoscopic removals of airway foreign bodies (FBs) were performed on all patients. For patients in acute respiratory distress, emergent air evacuation and/or resuscitations were performed first. Admission data, interventions, and clinical outcomes were recorded.
RESULTSA total of 39 patients were included in this study. The clinical severity was divided into three grades (Grades I, II, and III) according to the degree of dyspnea. Thirty-one patients were in Grade I dyspnea, and they simply underwent bronchoscopic FBs removals. PM resolved spontaneously and all patients recovered uneventfully. Six patients were in Grade II dyspnea, and emergent drainage preceded rigid bronchoscopy. They all recovered uneventfully under close observation. Two exhausted patients were in Grade III dyspnea. They died from large PM and bilateral pneumothorax, respectively, despite of aggressive interventions in our hospital.
CONCLUSIONSPM secondary to FBA could be life-threatening in some patients. The degree of dyspnea should be evaluated immediately, and patients in different dyspnea should be treated accordingly. For patients in Grade I dyspnea, simple bronchoscopic FBs removals could promise a good outcome. For patients in Grade II dyspnea, emergent air evacuation and/or resuscitation should precede a bronchoscopy before the children become exhausted.
Child, Preschool ; Female ; Foreign Bodies ; complications ; Humans ; Infant ; Male ; Mediastinal Emphysema ; diagnosis ; Pneumothorax ; diagnosis ; Retrospective Studies ; Subcutaneous Emphysema ; diagnosis
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