Graham Ruth, Bowen Nia, Singh Joy
Department of General Surgery, West Wales General Hospital, Carmarthen, UK.
BMJ Case Rep. 2014 Mar 10;2014:bcr2014203704. doi: 10.1136/bcr-2014-203704.
A 17-year-old male patient presented to A&E with swelling on the right side of his neck, extending to below the clavicle, associated with neck pain and dysphonia. On examination, subcutaneous supraclavicular and chest wall emphysema was noted. Clinical observations and bloods were normal. A chest X-ray and subsequent CT of the thorax showed evidence of pneumomediastinum and subcutaneous emphysema. The patient denied any history of trauma but admitted to inhalation of mephedrone 3 days previously. The patient was discussed with the regional cardiothoracic unit who advised conservative management. He was treated prophylactically with antibiotics and was initially kept nil by mouth, but diet was introduced 24 h later. He remained well, his dysphonia resolved and his subcutaneous emphysema improved. He was discharged after 3 days. He has not attended any formal follow-up but was well when contacted by phone.
一名17岁男性患者因颈部右侧肿胀就诊于急诊室，肿胀延伸至锁骨下方，伴有颈部疼痛和声音嘶哑。检查时，发现皮下锁骨上及胸壁气肿。临床观察和血液检查均正常。胸部X线及随后的胸部CT显示有纵隔气肿和皮下气肿的迹象。患者否认有任何外伤史，但承认3天前吸食了甲麻黄碱。与地区心胸科会诊后，建议采取保守治疗。对其进行了预防性抗生素治疗，最初禁食，24小时后开始进食。他情况良好，声音嘶哑症状消失，皮下气肿有所改善。3天后出院。他未进行任何正式随访，但电话联系时情况良好。
