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Unrecognized pneumothorax as a cause of intraspinal air
C Khodadadyan1, R Hoffmann, K Neumann
1Department of Trauma and Reconstructive Surgery, Free University of Berlin, Rudolf Virchow Medical Center, Germany.
Study Design:
This is a case report.
Objective:
A case of intraspinal air in a polytraumatized patient with unrecognized pneumothorax after blunt chest trauma is reported.
Summary Of Background Data:
In most cases, intraspinal air is associated with degenerative disc disease, epidural abscess, or synovial cyst, or it follows iatrogenic manipulation. Scialdone and Wagle first reported a case of intraspinal air due to a laceration of the right main bronchus. No previous case of intraspinal air after a simple unsuspected pneumothorax following blunt chest trauma has been reported.
Methods:
During routine x-ray and computed tomography examination of a polytraumatized patient, an unsuspected pneumothorax due to a rib fracture was detected in a thorax computed tomography scan. Computed tomography scans of the cervical spine showed a collection of intraspinal air.
Results:
The computed tomography examination of a polytraumatized patient with an unsuspected pneumothorax after blunt chest trauma showed the embolization of air in the paravertebral vein plexus and in the intraspinal canal.
Conclusion:
These observations suggest a wider indication for computed tomography scans of the thorax in blunt chest trauma. Also, whenever intraspinal air is found in the diagnostic course of a traumatized patient, a hidden pneumothorax should be suspected and ruled out.