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Published on: September 26, 2019
Systemic emphysema accompanying marked undernutrition
Yuichi Takano1,2, Hiroaki Tanaka3, Michiari Kawamo1
1Department of Critical Care and Emergency Medicine Showa University Fujigaoka Hospital Yokohama Kanagawa Japan.
Case:
A 38-year-old mentally retarded woman was transported to the emergency room for marked undernutrition. Two months prior, she had developed tooth decay and her food intake decreased severely. Over 2 months, her weight decreased from 47 to 31 kg (-16 kg). Computed tomography (CT) revealed extensive subcutaneous, mediastinal, and retroperitoneal emphysema. She was hospitalized and treatment with central venous hyperalimentation and antibiotics was initiated. CT performed 3 weeks after hospitalization showed that the systemic emphysema had completely disappeared.
Outcome:
She progressed favorably and was transferred to a specialized psychiatric hospital for further treatment.
Conclusion:
Regardless of the cause, this rare complication must be taken into account when treating patients suffering from long-term starvation or undernutrition. Whole-body management including nutritional management and careful follow-up observations are appropriate for treating this condition.
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