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Spontaneous pneumomediastinum with concurrent pneumorrhachis.

Jung H, Lee SC, Lee DH, Kim GJ - Korean J Thorac Cardiovasc Surg (2014)

Bottom Line: The presence of air in the spinal canal, known as concurrent pneumorrhachis, is an extremely rare epiphenomenon of spontaneous pneumomediastinum.We report a rare case of spontaneous pneumomediastinum with pneumorrhachis associated with influenza.The patient was diagnosed without invasive procedures, was managed with supportive treatment, and recovered without any complications.

View Article: PubMed Central - PubMed

Affiliation: Department of Thoracic and Cardiovascular Surgery, Kyungpook National University Hospital, Kyungpook National University School of Medicine.

ABSTRACT
Spontaneous pneumomediastinum is a very uncommon entity that is defined as the presence of free air in the mediastinum without an obvious etiology. The presence of air in the spinal canal, known as concurrent pneumorrhachis, is an extremely rare epiphenomenon of spontaneous pneumomediastinum. We report a rare case of spontaneous pneumomediastinum with pneumorrhachis associated with influenza. The patient was diagnosed without invasive procedures, was managed with supportive treatment, and recovered without any complications.

No MeSH data available.


Related in: MedlinePlus

Computed tomography of the chest confirming pneumomediastinum with concurrent pneumorrhachis. (A) Computed tomography of the chest demonstrating air dissection along the bronchovascular sheath (white arrow) and the presence of air in the dorsum of the spinal canal (black arrow). (B) Coronal view of the computed tomography image showing air entering the spinal canal through the neural foramen (arrow) combined with right pneumothorax and subcutaneous emphysema.
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f2-kjtcvs-47-569: Computed tomography of the chest confirming pneumomediastinum with concurrent pneumorrhachis. (A) Computed tomography of the chest demonstrating air dissection along the bronchovascular sheath (white arrow) and the presence of air in the dorsum of the spinal canal (black arrow). (B) Coronal view of the computed tomography image showing air entering the spinal canal through the neural foramen (arrow) combined with right pneumothorax and subcutaneous emphysema.

Mentions: A 17-year-old adolescent male patient visited a primary care clinic for cough, sputum, and chills. Medication was administered, and he was discharged that night. The next day, he returned to the hospital with intractable cough, fever, and pleuritic left chest pain. He was referred to emergency Department of Kyungpook National University Hospital for suspected pneumonia. His initial vital signs were as follows: blood pressure, 120/60 mmHg; pulse rate, 92 beats/min; body temperature, 38.3°C; and respiration rate, 36 breaths/min. He was alert and cooperative on physical examination without any neurological deficits. He had a history of asthma, but was not asthmatic at presentation. In addition, he had not experienced any traumatic injuries. There were no abnormal laboratory findings except for a C-reactive protein level of 4.94 mg/dL. Chest radiography revealed pneumomediastinum with a slight pneumonic infiltration in the left lower lung field (Fig. 1). Subsequent computed tomography of the chest confirmed the pneumomediastinum and identified concurrent pneumorrhachis (Fig. 2). The patient’s initial treatment was supportive care including no oral intake, antibiotics, antipyretics, and fluid therapy. Three days after admission, an esophagography was performed and revealed no injury to the digestive organs; thus, the patient was permitted to begin oral intake. He was eventually diagnosed with influenza by serology and an antiviral agent was administered. Thereafter, his symptoms improved, and his pneumomediastinum and pneumorrhachis simultaneously resolved. The patient was discharged on the seventh day of hospitalization, and he appeared well without sequelae in the outpatient clinic one week later.


Spontaneous pneumomediastinum with concurrent pneumorrhachis.

Jung H, Lee SC, Lee DH, Kim GJ - Korean J Thorac Cardiovasc Surg (2014)

Computed tomography of the chest confirming pneumomediastinum with concurrent pneumorrhachis. (A) Computed tomography of the chest demonstrating air dissection along the bronchovascular sheath (white arrow) and the presence of air in the dorsum of the spinal canal (black arrow). (B) Coronal view of the computed tomography image showing air entering the spinal canal through the neural foramen (arrow) combined with right pneumothorax and subcutaneous emphysema.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4279841&req=5

f2-kjtcvs-47-569: Computed tomography of the chest confirming pneumomediastinum with concurrent pneumorrhachis. (A) Computed tomography of the chest demonstrating air dissection along the bronchovascular sheath (white arrow) and the presence of air in the dorsum of the spinal canal (black arrow). (B) Coronal view of the computed tomography image showing air entering the spinal canal through the neural foramen (arrow) combined with right pneumothorax and subcutaneous emphysema.
Mentions: A 17-year-old adolescent male patient visited a primary care clinic for cough, sputum, and chills. Medication was administered, and he was discharged that night. The next day, he returned to the hospital with intractable cough, fever, and pleuritic left chest pain. He was referred to emergency Department of Kyungpook National University Hospital for suspected pneumonia. His initial vital signs were as follows: blood pressure, 120/60 mmHg; pulse rate, 92 beats/min; body temperature, 38.3°C; and respiration rate, 36 breaths/min. He was alert and cooperative on physical examination without any neurological deficits. He had a history of asthma, but was not asthmatic at presentation. In addition, he had not experienced any traumatic injuries. There were no abnormal laboratory findings except for a C-reactive protein level of 4.94 mg/dL. Chest radiography revealed pneumomediastinum with a slight pneumonic infiltration in the left lower lung field (Fig. 1). Subsequent computed tomography of the chest confirmed the pneumomediastinum and identified concurrent pneumorrhachis (Fig. 2). The patient’s initial treatment was supportive care including no oral intake, antibiotics, antipyretics, and fluid therapy. Three days after admission, an esophagography was performed and revealed no injury to the digestive organs; thus, the patient was permitted to begin oral intake. He was eventually diagnosed with influenza by serology and an antiviral agent was administered. Thereafter, his symptoms improved, and his pneumomediastinum and pneumorrhachis simultaneously resolved. The patient was discharged on the seventh day of hospitalization, and he appeared well without sequelae in the outpatient clinic one week later.

Bottom Line: The presence of air in the spinal canal, known as concurrent pneumorrhachis, is an extremely rare epiphenomenon of spontaneous pneumomediastinum.We report a rare case of spontaneous pneumomediastinum with pneumorrhachis associated with influenza.The patient was diagnosed without invasive procedures, was managed with supportive treatment, and recovered without any complications.

View Article: PubMed Central - PubMed

Affiliation: Department of Thoracic and Cardiovascular Surgery, Kyungpook National University Hospital, Kyungpook National University School of Medicine.

ABSTRACT
Spontaneous pneumomediastinum is a very uncommon entity that is defined as the presence of free air in the mediastinum without an obvious etiology. The presence of air in the spinal canal, known as concurrent pneumorrhachis, is an extremely rare epiphenomenon of spontaneous pneumomediastinum. We report a rare case of spontaneous pneumomediastinum with pneumorrhachis associated with influenza. The patient was diagnosed without invasive procedures, was managed with supportive treatment, and recovered without any complications.

No MeSH data available.


Related in: MedlinePlus