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Concurrent Spontaneous Pneumomediastinum and Pneumorrhachis
Alexander J Heckman1, Michael Mohseni2, Armando Villanueva1
1Department of Internal Medicine, Mayo Clinic, Jacksonville, Florida.
The Journal of Emergency Medicine
|April 25, 2018
Summary
Spontaneous pneumomediastinum with pneumorrhachis and subcutaneous emphysema is rare but usually manageable with conservative care. Emergency physicians should investigate thoroughly to rule out serious underlying causes before opting for observation.
Area of Science:
- Emergency Medicine
- Radiology
- Thoracic Surgery
Background:
- Presents spontaneous pneumomediastinum, pneumorrhachis, and subcutaneous emphysema.
- These conditions can be alarming clinically and radiographically.
- Often managed conservatively after ruling out underlying causes.
Observation:
- A 20-year-old man presented with chest pain and subcutaneous emphysema.
- Imaging revealed pneumomediastinum, pneumorrhachis, and extensive subcutaneous emphysema.
- The patient was stable and discharged after two days.
Findings:
- Spontaneous pneumomediastinum, pneumorrhachis, and subcutaneous emphysema are rare.
- Thorough ED investigation is crucial to exclude life-threatening causes.
- Conservative management is suitable for patients without cardiorespiratory compromise or neurologic deficits.
Implications:
- Highlights the importance of recognizing and managing rare presentations of air leak syndromes.
- Emphasizes a conservative approach for stable patients.
- Informs emergency physicians about appropriate diagnostic and management strategies.
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