Subcutaneous emphysema, pneumothorax, pneumomediastinum, and pneumoperitoneum during colonoscopic balloon dilation: a case report

A 77-year-old woman underwent colonoscopic balloon dilatation for colonic stricture 1 year after laparoscopic anterior resection of sigmoid colon cancer. During the balloon dilatation, panfacial swelling and apnea were noted. Emergency endotracheal intubation was undertaken. Chest X-ray revealed diffuse subcutaneous emphysema and bilateral pneumothorax. We discuss the possible mechanism and management of this uncommon complication during therapeutic colonoscopy.     

An unusual cause of subcutaneous emphysema, pneumomediastinum and pneumoperitoneum

A 62 year old female with subcutaneous emphysema, pneumomediastinum and pneumoperitoneum, was observed. Pneumothorax, however, was not present. Laparotomy revealed a large infiltrate in the left lower abdomen, which had penetrated the anterior abdominal wall. Microscopically, a recurrence of previously diagnosed vulval carcinoma was demonstrated. Despite intensive treatment the patient died two months later.     

Subcutaneous emphysema and pneumomediastinum: a cause of low-voltage electrocardiogram

The authors report the occurrence of diffuse low voltage and the loss of R-waves in the precordial leads in a standard 12-lead electrocardiogram, suggestive of an anterior wall myocardial infarction, in a patient with subcutaneous emphysema and pneumomediastinum.     

Subcutaneous emphysema and pneumothorax complicating diagnostic colonoscopy

A case of subcutaneous emphysema and pneumothorax secondary to a diagnostic colonoscopy is presented. While 11 cases of retroperitoneal emphysema due to colonoscopy were identified in the literature, there are only two further reports of pneumothorax. Possible etiologic and therapeutic aspects are discussed.     

Subcutaneous emphysema,pneumoretroperitoneum, and pneumomediastinum following rectal surgery: Report of a case and review of the literature

Summary A case of retroperitoneal, mediastinal, and subcutaneous emphysema following rectal surgery is described. This complication has not been reported in medical literature. Treatment was based on the fear of a more extensive and irreversible situation, because on the basis of the single case, it could not be demonstrated that the intestinal gas was not associated with infection.     

Subcutaneous cervical emphysema and pneumomediastinum due to a lower gastrointestinal tract perforation

This case report describes a 69-year-old man presenting with an extensive subcutaneous emphysema in his neck and generalized peritonitis caused by a lower gastrointestinal tract perforation. This case emphasizes that subcutaneous emphysema patients with negative thoracic findings should be scrutinized for signs of retroperitoneal hollow viscus perforation.     

Subcutaneous emphysema and pneumomediastinum due to foreign body aspiration in children with asthma

Pneumomediastinum (PM) and subcutaneous emphysema (SCE) are well recognized as complications of acute asthma exacerbation in children with asthma. We present herein a report of three cases of asthmatic children who presented with PM and SCE found to be secondary to foreign body aspiration. The cases highlight that clinicians must remain vigilant for co-morbidities in an asthma exacerbation, and less common etiologies of PM and SCE, such as foreign body aspiration, should also be carefully considered in asthmatic children.     

Subcutaneous emphysema and pneumomediastinum secondary to dental extraction: a case report and literature review

Here, we present the case of a woman who suffered from acute dyspnea and right cheek and neck swelling during molar extraction. The use of a high-speed dental drill may introduce air into the soft tissue and lead to subcutaneous emphysema and pneumomediastinum. After a review of the literature, we found that subcutaneous emphysema and pneumomediastinum are rare complications secondary to dental extraction. We report this case because physicians in the emergency department may misdiagnose the symptoms as an allergic reaction. Dentists should be more aware of air leak during dental extraction.     

Spontaneous cervicothoracolumbar pneumorrhachis,pneumomediastinum and pneumoperitoneum

Introduction: Pneumorrhachis, or epidural pneumatosis, is a rare entity that is usually traumatic or iatrogenic. Usually, the epidural emphysema is limited to a few vertebral spaces. Less commonly, it is secondary to mediastinal air that tracks into the epidural space. Mediastinal air is usually associated with subcutaneous emphysema, but rarely is it associated with pneumopericardium or pneumoperitoneum. The cause of pneumomediastinum is usually identifiable on history or radiology. Methods: Report of a case. Results: We report the extremely rare simultaneous occurrence of self‐limiting cervicothoracolumbar pneumorrhachis, pneumomediastinum, cervical subcutaneous emphysema and pneumoperitoneum in a healthy 20‐year‐old gentleman in the absence of an identifiable cause. Conclusion: Extensive pneumorrhachis and pneumoperitoneum may simultaneously accompany pneumomediastinum and subcutaneous emphysema in the absence of an identifiable cause and still follow a benign clinical course. Please cite this paper as: Al‐Mufarrej F, Gharagozloo F, Tempesta B and Margolis M. Spontaneous cervicothoracolumbar pneumorrhachis, pneumomediastinum and pneumoperitoneum. The Clinical Respiratory Journal 2009; 3: 239–243.     

Subcutaneous emphysema secondary to pulmonary cavity in absence of pneumothorax or pneumomediastinum

Subcutaneous emphysema is a common condition occurring after chest injury. It may also be observed in association with pneumothorax or pneumomediastinum as a result of pathological changes in the respiratory tract. Spontaneous subcutaneous emphysema in absence of pneumothorax or pneumomediastinum is rare. We report a case of spontaneous subcutaneous emphysema in isolation secondary to fibrocavitatory lesion in the chest along with review of the literature.     

Subcutaneous emphysema, pneumomediastinum, and potentially life-threatening tension pneumothorax. Pulmonary complications from arthroscopic shoulder decompression.

Subcutaneous emphysema, pneumomediastinum, and tension pneumothorax are previously unreported complications of shoulder arthroscopy with subacromial decompression. Three patients developed extensive subcutaneous emphysema, pneumomediastinum, and bilateral tension pneumothorax during or immediately after shoulder arthroscopy with subacromial decompression. The procedure was terminated and appropriate treatment was given. All three patients recovered completely with no residual damage. The complications are thought to be associated with the extravasation of air that may be drawn in from the lateral portal when the arthroscopic infusion pump and power shaver with suction are turned on. Early diagnosis, followed by immediate termination of the infusion pump and suction shaver along with appropriate treatment can be life-saving.