Minns Tania, Raj Ray, Clark Kate
Emergency Department, Royal Liverpool University Hospital, Liverpool, UK.
BMJ Case Rep. 2011 Oct 11;2011:bcr0920114840. doi: 10.1136/bcr.09.2011.4840.
A 21-year-old man presented to the emergency department with pain and swelling to the right side of his neck and chest wall with associated shortness of breath. Two days earlier, while playing football, he had been involved in a minor collision with another player where he was struck on the right side of his head, but had managed to continue playing. On examination, the patient had extensive cervical surgical emphysema. There were no further positive findings on respiratory and general examination. A chest x-ray demonstrated no rib or clavicular fractures and no pneumothorax. Therefore, a CT was undertaken to ascertain the cause of the surgical emphysema. This demonstrated a pneumomediastinum, pneumopericardium and extradural air in the spinal column in addition to the subcutaneous air. The CT identified no bony trauma and no other injuries. The symptoms resolved spontaneously and follow-up radiography, 9 days later, showed no residual air.
一名21岁男性因颈部右侧和胸壁疼痛、肿胀并伴有呼吸急促前往急诊科就诊。两天前踢足球时，他与另一名球员发生轻微碰撞，右侧头部被击中，但仍继续比赛。检查时，患者有广泛的颈部手术性气肿。呼吸和全身检查未发现其他阳性体征。胸部X线检查未发现肋骨或锁骨骨折，也没有气胸。因此，进行了CT检查以确定手术性气肿的原因。CT显示除皮下气肿外，还有纵隔气肿、心包积气和脊柱硬膜外积气。CT未发现骨质损伤及其他损伤。症状自行缓解，9天后的随访影像学检查显示无残留气体。
