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A Case Report of Pneumoretroperitoneum from Blunt Trauma in a Patient with Chronic Obstructive Pulmonary Disease

Annemarie Daecher1, Brittany Hartman1, James Krueger1,2

  • 1Albert Einstein Medical Center, Department of Emergency Medicine, Philadelphia, Pennsylvania.

Clinical Practice and Cases in Emergency Medicine
|February 14, 2024
PubMed
Abstract

Insights

Blunt trauma can cause pneumomediastinum via the Macklin effect. This case shows how chronic obstructive pulmonary disease exacerbation and cardiac arrest led to pneumoretroperitoneum, a rare complication.

Area of Science:

  • Medicine
  • Pulmonology
  • Trauma Surgery

Background:

  • Pneumomediastinum, a rare complication of blunt trauma, often results from the Macklin effect.
  • The Macklin effect involves alveolar rupture, air dissection along bronchovascular sheaths, and mediastinal spread.
  • Pneumomediastinum is infrequently associated with pneumoretroperitoneum.

Purpose of the Study:

  • To report a rare case of pneumoretroperitoneum following a fall in a patient with chronic obstructive pulmonary disease exacerbation.
  • To illustrate the potential complications of blunt trauma, particularly in patients with pre-existing lung conditions.

Main Methods:

  • Case report presentation.
  • Review of patient's medical history and clinical course.
  • Discussion of the pathophysiology of pneumomediastinum and its rare association with pneumoretroperitoneum.

Main Results:

  • A patient experiencing cardiac arrest after a fall during a chronic obstructive pulmonary disease exacerbation developed pneumoretroperitoneum.
  • This case demonstrates an unusual sequela of blunt trauma in the context of significant underlying pulmonary disease.

Conclusions:

  • Blunt trauma can lead to serious complications, including pneumoretroperitoneum.
  • Pre-existing lung pathology, such as chronic obstructive pulmonary disease, can exacerbate trauma complications.
  • Understanding these interactions is crucial for managing patients with blunt trauma and underlying respiratory conditions.

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