Steele Amanda, Jabbour Joe, Fischer Paul D, O'Neill John G
Department of Otolaryngology, The Tweed Hospital, Tweed Heads, New South Wales, Australia.
Department of Emergency, The Tweed Hospital, Tweed Heads, New South Wales, Australia.
Am J Case Rep. 2018 Oct 27;19:1279-1282. doi: 10.12659/AJCR.911980.
BACKGROUND Pneumomediastinum is an uncommon clinical condition that usually occurs spontaneously, or is caused by blunt thoracic or abdominal trauma. This report is of a rare case of pneumomediastinum caused by blunt neck trauma in an adult and describes the clinical and radiological features and the principles of clinical management. CASE REPORT A 23-year-old man presented with increased neck swelling, dysphonia and pain on swallowing (odynophagia) after blunt neck trauma during a rugby game. Chest X-ray and computed tomography (CT) showed features that were consistent with pneumomediastinum, including extensive subcutaneous emphysema. The patient was intubated and monitored in the intensive care unit (ICU) and managed with early stabilization of the airway and with conservative methods. He had no complications on clinical follow-up following hospital discharge. CONCLUSIONS Although pneumomediastinum is an uncommon condition, the complications can be fatal. This case highlights the importance of thoroughly investigating cases of subcutaneous emphysema and the importance of early stabilization of the airway.
背景 纵隔气肿是一种不常见的临床病症，通常为自发性发生，或由钝性胸腹部创伤所致。本报告介绍了一例罕见的成人钝性颈部创伤导致纵隔气肿的病例，并描述了其临床和放射学特征以及临床处理原则。病例报告 一名23岁男性在一场橄榄球比赛中颈部受到钝性创伤后，出现颈部肿胀加剧、声音嘶哑和吞咽疼痛（吞咽困难）。胸部X线和计算机断层扫描（CT）显示出与纵隔气肿相符的特征，包括广泛的皮下气肿。患者在重症监护病房（ICU）接受插管和监测，并通过早期气道稳定和保守方法进行治疗。出院后临床随访未出现并发症。结论 尽管纵隔气肿并不常见，但其并发症可能致命。本病例凸显了对皮下气肿病例进行全面调查的重要性以及早期气道稳定的重要性。
