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Traumatic mediastinal emphysema

W van der Horst, H Nier, W Meyer

    Archives of Orthopaedic and Traumatic Surgery. Archiv Fur Orthopadische Und Unfall-Chirurgie
    |January 1, 1980
    PubMed
    Summary
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    Traumatic mediastinal emphysema, often seen with severe injuries, presents with subcutaneous emphysema and pneumothorax. Diagnosis involves chest radiography, with treatments ranging from pleural drainage to cervical mediastinotomy or thoracotomy.

    Area of Science:

    • Trauma Surgery
    • Thoracic Surgery
    • Emergency Medicine

    Background:

    • Traumatic mediastinal emphysema is a serious condition often associated with severe combined injuries.
    • Key clinical signs include subcutaneous emphysema, crepitus (crackling sounds), and frequently pneumothorax.

    Purpose of the Study:

    • To outline the diagnostic and management strategies for traumatic mediastinal emphysema.
    • To emphasize the importance of timely intervention in severe cases.

    Main Methods:

    • Diagnosis relies on clinical presentation and chest radiography, which reveals air in the mediastinum.
    • Bronchoscopy is used to evaluate the tracheobronchial tree for ruptures.
    • Contrast esophagography detects esophageal injuries.

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    Main Results:

    • Radiography is crucial for identifying mediastinal air.
    • Pleural drainage is an emergency measure for pneumothorax.
    • Cervical mediastinotomy is indicated for progressive subcutaneous/mediastinal emphysema with circulatory compromise.

    Conclusions:

    • Prompt diagnosis and appropriate management, including potential surgical interventions like pleural drainage, cervical mediastinotomy, or thoracotomy, are critical.
    • Thorough examination of the tracheobronchial tree and esophagus is essential for comprehensive care.