Vacuum-assisted closure therapy is an alternative method for a massive subcutaneous emphysema treatment. It is easily applicable and shows rapid effectiveness in massive subcutaneous emphysema, intractable with chest tube drainage.
Chest Tubes ; Drainage ; Negative-Pressure Wound Therapy ; Subcutaneous Emphysema

Self-induced pneumoparotitis is a rare cause of swelling of the parotid gland. It has been reported to be a result of psychosomatic disorder, unintentional habit, and it is sometimes self-induced by patients to achieve secondary gain. We report a case of a 18-year-old man who had a self-induced pneumoparotitis complicated by recurrent parotitis, subcutaneous emphysema and pneumomediastinum. With repeated behavior of insufflation, parotid acini may rupture and air may extend into the retropharyngeal space, causing pneumomediastinum or pneumothorax. In self-induced cases, treatment should necessitate psychologic therapy for behavior modification.
Adolescent ; Behavior Therapy ; Humans ; Insufflation ; Mediastinal Emphysema ; Parotid Gland ; Parotitis ; Pneumothorax ; Psychophysiologic Disorders ; Rupture ; Subcutaneous Emphysema

Subcutaneous emphysema is the local tissue swelling caused by the gas entering the subcutaneous tissue through the tissue gap. Although subcutaneous emphysema is usually a nonfatal and self-limited disease, in severe cases, the gas may spread to the neck, mediastinum and chest, resulting in mediastinal emphysema and other serious complications. This article reviews the etiology, pathogenesis, clinical manifestations, diagnosis, differential diagnosis of subcutaneous emphysema related to dental therapy,and operations that may cause subcutaneous emphysema in stomatology department,as well as the treatment and prognosis of subcutaneous emphysema, with a view to providing some references for dentists.
Humans ; Diagnosis, Differential ; Mediastinal Emphysema/pathology* ; Subcutaneous Emphysema/therapy* ; Neck/pathology* ; Face

A case of extensive pneumomediastinum and subcutaneous emphysema is presented, after endotracheal intubation with a metallic endotracheal tube during laser epiglottectomy. A 69 year old woman had a laser tube intubation-related tracheal injury. The patient was managed with intubation and chest tube insertion as well as antibiotic treatment. The patient made a full and uncomplicated recovery and was discharged 10 days after the original injury. Aggressive surgical repair for such injuries is not always mandatory. In the absence of infectious complications, a conservative approach is an option for lesions 3 cm above the carina where it is possible to inflate a cuff. Urgent chest CT scanning subsequently can confirm extensive mediastinal and subcutaneous emphysema and probable tracheal laceration. The use of a laser tube during laser laryngeal microsurgery requires meticulous care.
Chest Tubes ; Female ; Humans ; Intubation ; Intubation, Intratracheal ; Lacerations ; Laser Therapy ; Mediastinal Emphysema ; Microsurgery ; Rupture ; Subcutaneous Emphysema ; Thorax

Hearing Loss, Sudden ; therapy ; Humans ; Hyperbaric Oxygenation ; adverse effects ; Male ; Middle Aged ; Neck ; Subcutaneous Emphysema ; etiology

Pulmonary mucormycosis is an uncommon fungal opportunistic infection found mainly in immunosuppressed patients or in patients with poorly controlled diabetes mellitus. A case of pulmonary mucormycosis complicated by pneumomediastinum and subcutaneous emphysema in small cell lung cancer has not yet been reported to date. A 61-year-old patient with a small cell lung cancer was in a course of clinical improvement with chemotherapy until the development of new bilateral lung lesions after the fourth round of chemotherapy. After diagnosing mucormycosis by a transbronchial lung biopsy of the new lesions, the condition of the patient improved with amphotericin B treatment, but radiographic cavitations of mucormycosis persisted. After 2.4 months of administering oral itraconazole medication, additional chemotherapy was performed due to cancer progression. Mucormycosis developed complicated by pneumomediastinum and subcutaneous emphysema, which resulted from fistula formation of the cavity lesion of the left side into the mediastinum. The patient died of a fungal sepsis despite a surgical resection of the left lesion.
Amphotericin B ; Biopsy ; Diabetes Mellitus ; Drug Therapy* ; Fistula ; Humans ; Itraconazole ; Lung ; Mediastinal Emphysema* ; Mediastinum ; Middle Aged ; Mucormycosis* ; Opportunistic Infections ; Sepsis ; Small Cell Lung Carcinoma* ; Subcutaneous Emphysema*

Since April 2009, outbreaks of the new influenza A (H1N1) virus have occurred worldwide. The spectrum of disease caused by H1N1 infection ranges from non-febrile, mild upper respiratory tract illness to severe or fatal pneumonia. Rapidly progressive respiratory diseases, such as acute respiratory distress syndrome and renal or multi-organ failure, have accounted for severely affected inpatients. Complex cases involving myocarditis, encephalitis, and myositis have been described. However, pulmonary air-leak syndrome, consisting of spontaneous pneumomediastinal emphysema, pneumothorax, and subcutaneous emphysema complicating pneumonia with the H1N1 virus, has not previously been reported in Korea. Here, we report a case of pulmonary air-leak syndrome complicating H1N1 infection that was resolved with an antiviral agent, high-flow oxygen, and fluid therapy.
Disease Outbreaks ; Emphysema ; Encephalitis ; Fluid Therapy ; Humans ; Influenza A Virus, H1N1 Subtype ; Influenza, Human ; Inpatients ; Korea ; Mediastinal Emphysema ; Myocarditis ; Myositis ; Oxygen ; Pneumonia ; Pneumothorax ; Respiratory Distress Syndrome, Adult ; Respiratory System ; Subcutaneous Emphysema ; Viruses

OBJECTIVETo analyze the diagnosis, treatment and prognosis of spontaneous pneumomediastinum (SPM) in children.

METHODA retrospective analysis of the clinical data of 18 children diagnosed with SPM in Yuying Children's Hospital Affiliated to Wenzhou Medical University from December 2007 to February 2013 was performed. Information of the sequelae and recurrence of SPM was obtained by telephone follow-up. SPM was diagnosed according to Versteegh's standard. SPM cases due to mechanical ventilation, trauma, inhaled foreign body or as a result of the underlying disease were not included. Also cases of secondary pneumothorax pneumomediastinum and neonatal mediastinal emphysema were excluded.

RESULTFifteen of 18 cases were boys and 3 were girls, the range of age was from 9 to 17 years. Predisposing factors included sport activities, severe cough or without a known cause. Clinical manifestations included chest pain, chest tightness, dyspnea, neck pain, back pain, foreign body sensation or pain on swallowing, throat pain of swelling. Chest CT of 18 cases showed pneumomediastinum, 8 cases displayed varied degrees of air in neck, chest; 18 cases of SPM responded well to bed rest, oxygen, antitussive and anti-infection treatment. Fifteen cases received chest CT or X-ray inspection after therapy, showing that the pneumomediastinum disappeared or significantly absorbed, 3 cases improved in clinical symptom. Among 18 patients, telephone follow-up of 14 were successful and 4 cases were lost. An average follow-up time was (24 ± 17) months. None of the cases had any serious consequences, and recurrence happened in one case.

CONCLUSIONChildren's spontaneous pneumomediastinum is a benign disease. When a child has chest pain or chest tightness, SPM should be considered after excluding the common diseases. SPM can be diagnosed in association with clinical feature and chest CT examination. Patients respond well to conservative therapy and most of them had no severe sequelae.

Adolescent ; Chest Pain ; diagnosis ; etiology ; Child ; Dyspnea ; diagnosis ; etiology ; Female ; Follow-Up Studies ; Humans ; Male ; Mediastinal Emphysema ; complications ; diagnosis ; therapy ; Oxygen Inhalation Therapy ; Prognosis ; Radiography, Thoracic ; Recurrence ; Subcutaneous Emphysema ; diagnosis ; etiology ; Tomography, X-Ray Computed