Division of Pediatric Emergency Medicine, Department of Pediatrics, University of Arkansas Medical Sciences, Little Rock and Arkansas and Arkansas Children's Hospital, Little Rock, Arkansas.
J Emerg Med. 2021 Nov;61(5):e116-e119. doi: 10.1016/j.jemermed.2021.09.019. Epub 2021 Nov 1.
Pneumorrhachis is an uncommon radiographic finding and is typically found in adult patients secondary to trauma or pneumocephalus. It is extremely rare in the pediatric population. Our case report describes a young boy who was found to have pneumorrhachis, but initially presented with an isolated back laceration.
An 8-year-old boy arrived to the emergency department as a transfer from an outside hospital after initially presenting with a back laceration. After laceration repair, he developed severe headache and vomiting when sitting upright from a supine position. He was found to have T3 fractures and pneumocephalus secondary to pneumorrhachis and was managed conservatively per neurosurgery recommendations. Why Should an Emergency Physician Be Aware of This?Although extremely rare in the pediatric population, pneumorrhachis must still be considered in any pediatric patient with a penetrating injury to the abdomen, respiratory tract, or spinal column. Cases without clear etiology require further evaluation for occult spinal injuries and fractures. Conservative management is typically sufficient, although certain situations require further intervention.
气胸是一种不常见的影像学表现，通常发生在成人患者中，继发于创伤或气颅。在儿科人群中极为罕见。我们的病例报告描述了一名年轻男孩，他被发现患有气胸，但最初表现为孤立的背部裂伤。
一名 8 岁男孩最初因背部裂伤被从外院转送至急诊部。裂伤修复后，当他从仰卧位坐起时，出现严重头痛和呕吐。他被发现 T3 骨折和气颅，继发于气胸和脊柱裂，根据神经外科建议接受保守治疗。为什么急诊医生应该了解这一点？
虽然在儿科人群中极为罕见，但对于任何有腹部、呼吸道或脊柱穿透伤的儿科患者，都必须考虑气胸。没有明确病因的病例需要进一步评估隐匿性脊柱损伤和骨折。通常，保守治疗就足够了，尽管某些情况需要进一步干预。
