Gokhale Sankalp, Gokhale Sanjay
Department of Neurology, Duke University School of Medicine, Durham, N.C., USA.
Med Princ Pract. 2014;23(2):177-9. doi: 10.1159/000353465. Epub 2013 Aug 13.
To report a rare case of spontaneous extracranial epidural emphysema.
An 18-year-old woman with a recent diagnosis of squamous cell carcinoma of the esophagus presented with acute onset of cough, dyspnea and subcutaneous emphysema. An esophageal endoscopy revealed an ulcerative lesion in the upper third of the esophagus that was diagnosed as squamous cell carcinoma. A computed tomographic scan of the chest showed spinal epidural emphysema in addition to pneumomediastinum and pneumoperitoneum. A few days later, the patient died of aspiration pneumonia and persistent epidural emphysema.
The spontaneous extracranial epidural emphysema in our case resulted from a bout of cough with tracking of air from the pneumomediastinum through the emaciated tissue planes into the epidural space.
报告一例罕见的自发性颅外硬膜外气肿病例。
一名18岁女性，近期被诊断为食管鳞状细胞癌，出现急性咳嗽、呼吸困难和皮下气肿。食管内镜检查发现食管上三分之一处有溃疡性病变，诊断为鳞状细胞癌。胸部计算机断层扫描显示除纵隔气肿和气腹外，还有脊髓硬膜外气肿。几天后，患者死于吸入性肺炎和持续性硬膜外气肿。
本例自发性颅外硬膜外气肿是由于一阵咳嗽，空气从纵隔通过消瘦的组织平面进入硬膜外间隙所致。
