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Pneumo-thorax/mediastinum/(retro)peritoneum/ scrotum – a full house of complications following JET ventilation

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ABSTRACT

We present a patient who presented to our clinic with airway obstruction secondary to oropharygeal cancer. He underwent emergent tracheostomy with JET ventilation, the latter resulting in a "full house" of barotraumatic complications including pneumothorax, pneumomediastinum, pneumoperitoneum, pneumoretroperitoneum and pneumo-scrotum. Free air, while sometimes dramatic as in our case, need not always be a cause for alarm and can often be managed expectantly. Our patient was treated with only a chest drain and otherwise made an uneventful recovery.

No MeSH data available.


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Axial slice triple contrast chest/abdominal CT showing mediastinal free air (arrows) and subcutaneous emphysema on the left.
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Figure 3: Axial slice triple contrast chest/abdominal CT showing mediastinal free air (arrows) and subcutaneous emphysema on the left.

Mentions: Clinically, the patient's cardiovascular status was stable with no signs of engorged neck veins. Furthermore, the abdomen was soft with normal bowel sounds. Scrotal examination showed an enlarged and tender scrotum and the clinical diagnosis of pneumo-scrotum was made. The chest drain was swinging normally without any bubbles. Blood tests revealed mild leukocytosis and C-reactive protein of 85. To better evaluate the extent of mediastinal/ abdominal/ scrotal free air, a triple contrast chest/abdominal CT. This showed copious bilateral subcutaneous emphysema, small pneumothoraces bilaterally, mediastinal, intra-abdominal, retroperitoneal and scrotal free air (Figs. 2, 3).


Pneumo-thorax/mediastinum/(retro)peritoneum/ scrotum – a full house of complications following JET ventilation
Axial slice triple contrast chest/abdominal CT showing mediastinal free air (arrows) and subcutaneous emphysema on the left.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC5384314&req=5

Figure 3: Axial slice triple contrast chest/abdominal CT showing mediastinal free air (arrows) and subcutaneous emphysema on the left.
Mentions: Clinically, the patient's cardiovascular status was stable with no signs of engorged neck veins. Furthermore, the abdomen was soft with normal bowel sounds. Scrotal examination showed an enlarged and tender scrotum and the clinical diagnosis of pneumo-scrotum was made. The chest drain was swinging normally without any bubbles. Blood tests revealed mild leukocytosis and C-reactive protein of 85. To better evaluate the extent of mediastinal/ abdominal/ scrotal free air, a triple contrast chest/abdominal CT. This showed copious bilateral subcutaneous emphysema, small pneumothoraces bilaterally, mediastinal, intra-abdominal, retroperitoneal and scrotal free air (Figs. 2, 3).

View Article: PubMed Central - PubMed

ABSTRACT

We present a patient who presented to our clinic with airway obstruction secondary to oropharygeal cancer. He underwent emergent tracheostomy with JET ventilation, the latter resulting in a "full house" of barotraumatic complications including pneumothorax, pneumomediastinum, pneumoperitoneum, pneumoretroperitoneum and pneumo-scrotum. Free air, while sometimes dramatic as in our case, need not always be a cause for alarm and can often be managed expectantly. Our patient was treated with only a chest drain and otherwise made an uneventful recovery.

No MeSH data available.


Related in: MedlinePlus