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Báo cáo y học: " Subcutaneous emphysema in a case of infective sinusitis: a case report"

Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Subcutaneous emphysema in a case of infective sinusitis: a case report. | Zakaria and Khwaja Journal of Medical Case Reports 2010 4 235 http www.jmedicalcasereports.eom content 4 1 235 jAl JOURNALOF medical ÌỤr case REPORTS CASE REPORT Open Access Subcutaneous emphysema in a case of infective sinusitis a case report Rasheed Zakaria1 Haris Khwaja2 Abstract Introduction Subcutaneous emphysema with pneumomediastinum is a rare phenomenon with a high morbidity and may occur spontaneously. Case presentation A 30-year-old Caucasian man presented with sudden onset of a painful swollen neck and was found via clinical and radiological examination to have subcutaneous emphysema. A swallow study showed no oesophageal perforation. Computed tomography of his neck and thorax demonstrated pneumomediastinum but no other pathology. Management was conservative with intravenous antibiotics fluids and no oral intake. He had a history of a productive cough and a flexible nasoendoscopy found purulent sinusitis which was treated with topical nasal washes. The patient was discharged after 72 hours and will be followed up by the otolaryngologyhead and neck service. Conclusions Infective sinusitis is a rare cause of subcutaneous emphysema and pneumomediastinum. It may be managed conservatively provided there is early recognition and exclusion of more serious pathology such as a ruptured trachea or oesophagus. Introduction Subcutaneous and mediastinal emphysema is an uncommon phenomenon with a significant morbidity and mortality. It is usually secondary to infection of the mediastinum pericardium or lung parenchyma and is particularly associated with mechanical ventilation soft tissue infections and underlying pathology of the trachea oesophagus or bronchial tree. Prompt recognition with treatment of sepsis and repair of any perforated viscus if indicated are the main features of management. Here we describe an unusual case of a patient with a short history of seemingly spontaneous subcutaneous emphysema and pneumomediastinum. Forceful paroxysms of coughing due to