小儿哮喘急性发作期严重皮下气肿的无创治疗：一例报告及文献复习
Non-invasive management of severe subcutaneous emphysema in a pediatric asthma exacerbation: a case report and review.
作者信息
Aljohani Amal H, Alsufiani Hamdi, Ahmed Ghousia
机构信息
Division of Allergy and Clinical Immunology, Pediatric Department, College of Medicine, Taibah University, Madinah, Saudi Arabia.
Division of Pulmonary Medicine, Pediatric Department, King Salman Medical City, Madinah, Saudi Arabia.
出版信息
Int J Emerg Med. 2024 Dec 31;17(1):203. doi: 10.1186/s12245-024-00804-0.
BACKGROUND
Spontaneous pneumomediastinum (SPM) and subcutaneous emphysema (SE) are rare, severe, and potentially life-threatening complications associated with asthma exacerbation. Most of these conditions are benign and self-limiting. However, the overlapping symptoms between asthma exacerbation and pneumomediastinum (PM) may delay diagnosis. These conditions can usually be managed through conservative treatment, although unfamiliarity with this presentation may lead some physicians to consider surgical intervention.
CASE PRESENTATION
We report a unique case involving a 9-year-old patient experiencing a severe bronchial asthma attack and right lobe atelectasis complicated by PM and severe SE that extended to his left eye. The condition was successfully treated conservatively, with aggressive management of asthma exacerbation and close monitoring in the intensive care unit.
CONCLUSION
This case highlights the effectiveness of conservative management of PM and SE with appropriate asthma exacerbation treatment. Early diagnosis and management can lead to a favorable prognosis and a relatively brief hospital stay.
CLINICAL TRIAL NUMBER
Not applicable.
背景
自发性纵隔气肿（SPM）和皮下气肿（SE）是与哮喘急性发作相关的罕见、严重且可能危及生命的并发症。这些情况大多为良性且具有自限性。然而，哮喘急性发作与纵隔气肿（PM）之间的重叠症状可能会延迟诊断。这些病症通常可通过保守治疗进行处理，不过，由于对这种表现不熟悉，可能会导致一些医生考虑手术干预。
病例报告
我们报告了一例独特病例，一名9岁患者发生严重支气管哮喘发作及右肺叶肺不张，并伴有PM及严重SE，且气肿扩展至左眼。通过积极治疗哮喘急性发作并在重症监护病房密切监测，该病症经保守治疗成功治愈。
结论
本病例突出了对PM和SE进行保守治疗并适当治疗哮喘急性发作的有效性。早期诊断和处理可带来良好预后及相对较短的住院时间。
临床试验编号
不适用。
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