RESUMO
Subcutaneous emphysema is the local tissue swelling caused by the gas entering the subcutaneous tissue through the tissue gap. Although subcutaneous emphysema is usually a nonfatal and self-limited disease, in severe cases, the gas may spread to the neck, mediastinum and chest, resulting in mediastinal emphysema and other serious complications. This article reviews the etiology, pathogenesis, clinical manifestations, diagnosis, differential diagnosis of subcutaneous emphysema related to dental therapy,and operations that may cause subcutaneous emphysema in stomatology department,as well as the treatment and prognosis of subcutaneous emphysema, with a view to providing some references for dentists.
Assuntos
Enfisema Mediastínico , Enfisema Subcutâneo , Humanos , Diagnóstico Diferencial , Enfisema Mediastínico/diagnóstico , Enfisema Mediastínico/etiologia , Enfisema Mediastínico/patologia , Enfisema Subcutâneo/diagnóstico , Enfisema Subcutâneo/etiologia , Enfisema Subcutâneo/terapia , Pescoço/patologia , FaceRESUMO
Subcutaneous emphysema is the local tissue swelling caused by the gas entering the subcutaneous tissue through the tissue gap. Although subcutaneous emphysema is usually a nonfatal and self-limited disease, in severe cases, the gas may spread to the neck, mediastinum and chest, resulting in mediastinal emphysema and other serious complications. This article reviews the etiology, pathogenesis, clinical manifestations, diagnosis, differential diagnosis of subcutaneous emphysema related to dental therapy,and operations that may cause subcutaneous emphysema in stomatology department,as well as the treatment and prognosis of subcutaneous emphysema, with a view to providing some references for dentists.
Assuntos
Humanos , Diagnóstico Diferencial , Enfisema Mediastínico/patologia , Enfisema Subcutâneo/terapia , Pescoço/patologia , FaceRESUMO
Spontaneous pneumomediastinum (SPM) and Loculated pneumothorax (LPNX) are both generally rare clinical and radiological conditions associated with Coronavirus Disease 2019 (COVID-19). We report for the first time clinical data and radiological chest CT imaging of two patients affected by COVID-pneumonia associated with early radiological findings of SPM and LPNX.
Assuntos
Infecções por Coronavirus , Enfisema Mediastínico , Pandemias , Pneumonia Viral , Pneumotórax , Adulto , Idoso , Betacoronavirus , COVID-19 , Infecções por Coronavirus/complicações , Infecções por Coronavirus/diagnóstico por imagem , Infecções por Coronavirus/patologia , Feminino , Humanos , Masculino , Enfisema Mediastínico/diagnóstico por imagem , Enfisema Mediastínico/patologia , Enfisema Mediastínico/virologia , Pneumonia Viral/complicações , Pneumonia Viral/diagnóstico por imagem , Pneumonia Viral/patologia , Pneumotórax/diagnóstico por imagem , Pneumotórax/patologia , Pneumotórax/virologia , SARS-CoV-2 , Tomografia Computadorizada por Raios XAssuntos
Betacoronavirus , Infecções por Coronavirus/diagnóstico por imagem , Enfisema Mediastínico/diagnóstico por imagem , Enfisema Mediastínico/virologia , Pneumonia Viral/diagnóstico por imagem , Adulto , COVID-19 , Infecções por Coronavirus/patologia , Humanos , Masculino , Enfisema Mediastínico/patologia , Pandemias , Pneumonia Viral/patologia , SARS-CoV-2 , Tomografia Computadorizada por Raios XRESUMO
The purpose of this study was to evaluate the added value of postmortem magnetic resonance imaging (MRI) compared to postmortem computed tomography (CT) and autopsy in cases of fatal hanging. In addition, the study analyzed the strengths of each examination method regarding typical injuries in these cases. We investigated a cohort of 25 decedents who underwent CT, MRI and autopsy. Two radiologists assessed all MR images of the head and neck as well as the corresponding CT images. The results were compared to autopsy findings by retrospectively analyzing the autopsy reports. Postmortem MRI revealed intramuscular hemorrhages in a large number of cases, however, autopsy did not confirm all of the detected hemorrhages. CT and autopsy detected fractures in several cases, whereas MRI showed a fracture in just one single case. Other previously described vital signs and relevant findings, such as fracture-related gas bubbles, soft tissue emphysema or pneumomediastinum, were observed in only a few individual cases. MRI provided added diagnostic value in the detection of soft tissue injuries and lymph node swelling in fatal hangings. As an adjunct to autopsy, postmortem MRI may reveal additional hemorrhages, which might be missed at autopsy. Since standard MRI demonstrated low sensitivity for the detection of fractures, an additional imaging modality or autopsy is required to overcome this limitation.
Assuntos
Asfixia/diagnóstico por imagem , Asfixia/patologia , Autopsia/métodos , Imageamento por Ressonância Magnética , Lesões do Pescoço/diagnóstico por imagem , Lesões do Pescoço/patologia , Tomografia Computadorizada por Raios X , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Edema Encefálico/diagnóstico por imagem , Edema Encefálico/patologia , Criança , Edema/diagnóstico por imagem , Edema/patologia , Enfisema/diagnóstico por imagem , Enfisema/patologia , Feminino , Fraturas Ósseas/diagnóstico por imagem , Fraturas Ósseas/patologia , Fraturas de Cartilagem/diagnóstico por imagem , Fraturas de Cartilagem/patologia , Glote/diagnóstico por imagem , Glote/patologia , Hemorragia/diagnóstico por imagem , Hemorragia/patologia , Humanos , Osso Hioide/diagnóstico por imagem , Osso Hioide/lesões , Osso Hioide/patologia , Hemorragias Intracranianas/diagnóstico por imagem , Hemorragias Intracranianas/patologia , Linfonodos/diagnóstico por imagem , Linfonodos/patologia , Masculino , Enfisema Mediastínico/diagnóstico por imagem , Enfisema Mediastínico/patologia , Pessoa de Meia-Idade , Músculos do Pescoço/diagnóstico por imagem , Músculos do Pescoço/patologia , Cartilagem Tireóidea/diagnóstico por imagem , Cartilagem Tireóidea/lesões , Cartilagem Tireóidea/patologia , Imagem Corporal Total , Adulto JovemAssuntos
Enfisema Mediastínico/diagnóstico por imagem , Enfisema Mediastínico/cirurgia , Toracoscopia/métodos , Adulto , Assistência ao Convalescente , Tubos Torácicos , Humanos , Masculino , Enfisema Mediastínico/patologia , Próteses e Implantes , Recidiva , Sucção/métodos , Tomografia Computadorizada por Raios X/métodos , Resultado do TratamentoAssuntos
Asma/complicações , Pneumorraque/etiologia , Adolescente , Asma/diagnóstico , Asma/patologia , Humanos , Masculino , Enfisema Mediastínico/complicações , Enfisema Mediastínico/diagnóstico , Enfisema Mediastínico/patologia , Pneumorraque/diagnóstico , Pneumorraque/patologia , Radiografia Torácica , Índice de Gravidade de DoençaRESUMO
We present the case of an adult white man found dead in a psychiatric institution with fine white powder (monoammonium phosphate) deposited over the entire face after he insufflated the contents of a dry chemical fire extinguisher. Fine white powder was present within the mouth and sinuses and lined the upper airways. On opening the thoracic cavity, approximately 500 g of fine white powder was present within the right thoracic cavity. The esophagus was ruptured. Traumatic emphysema of the posterior sternum wall was present (pneumomediastinum). The ethmoid bones were fractured by the barotrauma. On polarization of the lung tissue, birefringent material was noted deposited along the bronchovascular sheaths and in a subpleural distribution. Death was probably due to a combination of barotrauma and asphyxia.This case study provides strong evidence in support of the etiology and pathophysiology of the Macklin effect. It also provides for the first visual evidence of the phenomenon.
Assuntos
Asfixia/patologia , Barotrauma/patologia , Sistemas de Combate a Incêndio , Insuflação/efeitos adversos , Adulto , Esôfago/lesões , Esôfago/patologia , Osso Etmoide/lesões , Osso Etmoide/patologia , Hospitais Psiquiátricos , Humanos , Pulmão/patologia , Masculino , Enfisema Mediastínico/patologia , Transtornos do Humor/psicologia , Fosfatos/efeitos adversos , Fosfatos/análise , Pós , Ruptura , Fraturas Cranianas/patologiaRESUMO
Dermatomyositis is a rare connective tissue disease of unknown origin, including inflammatory myopathy and cutaneous manifestations. Several pulmonary complications associated to dermatomyositis were described; especially interstitial lung disease. Some rare and particular pulmonary complications were reported in the literature such as pneumodiastinum and pneumothorax. We are describing here, a case report about a female patient, who presented with dermatomyositis associated to pneumomediastinum as a severe and lethal complication without pneumothorax. It is a novel observation depicting this severe and rare complication. Brutal dyspnea and cervical subcutaneous crackling are alarming signs that should make practitioners think about this complication.
Assuntos
Dermatomiosite/complicações , Enfisema Mediastínico/etiologia , Dermatomiosite/patologia , Feminino , Humanos , Enfisema Mediastínico/patologia , Pessoa de Meia-Idade , Enfisema Subcutâneo/etiologia , Enfisema Subcutâneo/patologiaRESUMO
No disponible
Assuntos
Humanos , Masculino , Feminino , 34600/métodos , Neoplasias Pulmonares/classificação , Neoplasias Pulmonares/epidemiologia , Estadiamento de Neoplasias/classificação , Estadiamento de Neoplasias/métodos , Enfisema Mediastínico/patologia , Neoplasias do Mediastino/complicações , Neoplasias do Mediastino/epidemiologia , Mediastino/patologiaRESUMO
We present the case of a 41-year-old woman who was fatally injured during a witnessed lightning strike event and in whom autopsy revealed the unusual keraunopathological finding of overt pneumomediastinum. The possible pathophysiological mechanism(s) of causation of this phenomenon are discussed, with specific reference also to the "Macklin" effect and the role of blast overpressures associated with lightning strike. It is suggested that the latter may lead to sudden alveolar rupture, with subsequent rapid tracking of air along bronchovascular sheaths in a centripetal manner toward the hilum of the lung and thus into the mediastinum. A review of the blast literature suggests that this victim would have been exposed to a blast pressure wave of approximately 29-psi (200 kPa) to 72-psi (500 kPa) magnitude.
Assuntos
Lesões por Ação do Raio/complicações , Enfisema Mediastínico/etiologia , Enfisema Mediastínico/patologia , Adulto , Evolução Fatal , Feminino , HumanosAssuntos
Enfisema Mediastínico/etiologia , Pneumotórax/complicações , Enfisema Subcutâneo/etiologia , Dispneia/etiologia , Humanos , Masculino , Enfisema Mediastínico/patologia , Pessoa de Meia-Idade , Pneumotórax/etiologia , Pneumotórax/patologia , Enfisema Subcutâneo/patologia , Traumatismos Torácicos/complicaçõesRESUMO
No disponible
Assuntos
Humanos , Masculino , Idoso de 80 Anos ou mais , Diagnóstico de Pneumomediastino/métodos , Enfisema Mediastínico/etiologia , Enfisema Mediastínico/história , Enfisema/complicações , Deiscência da Ferida Operatória/complicações , Deiscência da Ferida Operatória/cirurgia , Neoplasias do Colo Sigmoide/cirurgia , Neoplasias do Colo Sigmoide , Colo Sigmoide/cirurgia , Colo Sigmoide , Anastomose Cirúrgica/instrumentação , Anastomose Cirúrgica/métodos , Anastomose Cirúrgica , Laparoscopia/métodos , Tomografia/métodos , Enfisema Mediastínico/patologia , Enfisema MediastínicoRESUMO
A two-year-old castrated male Pomeranian dog was referred with the chief complaints of coughing and subcutaneous emphysema. On physical examination, the crepitant areas were palpable. When auscultated, the right chest was absent of respiratory sound, while the sound of the opposite side was enhanced. Radiographs presented pneumothorax and pneumomediastinum. On computed tomography, hypoattenuated bulla-like lesion at right middle lung lobe and trapped air in mediastinum were shown. After patient stabilization, surgery for excision of affected lobe was performed. During follow-up period, there were no recurrence and complication on radiographic examination. Based on clinical and pathological findings, the dog was diagnosed as congenital lobar emphysema.
Assuntos
Doenças do Cão/congênito , Enfisema/veterinária , Enfisema Mediastínico/veterinária , Pneumotórax/veterinária , Animais , Doenças do Cão/diagnóstico por imagem , Doenças do Cão/patologia , Cães , Enfisema/complicações , Enfisema/congênito , Enfisema/patologia , Masculino , Enfisema Mediastínico/complicações , Enfisema Mediastínico/diagnóstico por imagem , Enfisema Mediastínico/patologia , Pneumotórax/complicações , Pneumotórax/diagnóstico por imagem , Pneumotórax/patologia , Radiografia/veterinária , Tomografia Computadorizada por Raios X/veterináriaRESUMO
Spontaneous Pneumomediastinum is a rare clinical situation in pediatric emergency services, sometimes it presents with guiding symptoms, but in other occasions in a very nonspecific way. Definitely, needs to be highly suspected, emphasizing in the anamnesis the antecedent of intense physical exercise before the development of the triggering symptoms that determinates the consult, generally having a good evolution that gets solved in 3-4 days. There is a pediatric clinical case presented, that permits us to discuss the more relevant aspects of the clinical presentation, diagnosis methods and the updated management, in pediatric emergency services.
Assuntos
Masculino , Humanos , Criança , Enfisema Mediastínico/diagnóstico , Enfisema Mediastínico/patologia , Enfisema Mediastínico/terapia , Cervicalgia , Cervicalgia/diagnósticoRESUMO
Spontaneous pneumomediastinum is the presence of free air contained within the mediastinum, frequently associated with subcutaneous emphysema and of atraumatic origin. Frequency during childbirth is 1 in 100,000. We report the case of a 19 year old woman without respiratory disease history, in her first pregnancy with 39.5 weeks of gestation patient had, prolonged latent phase and sudden postpartum onset of dyspnea, thoracic pain and subcutaneous emphysema. Simple X ray film and thoracic tomography revealed the presence of free air in the mediastinum. The association of pneumomediastinum during delivery is an uncommon event.
Assuntos
Enfisema Mediastínico/etiologia , Período Pós-Parto , Enfisema Subcutâneo/etiologia , Feminino , Humanos , Enfisema Mediastínico/diagnóstico , Enfisema Mediastínico/patologia , Gravidez , Enfisema Subcutâneo/diagnóstico , Enfisema Subcutâneo/patologia , Tomografia Computadorizada por Raios X , Adulto JovemRESUMO
This report describes a case of severe spontaneous tension pneumopericardium with concurrent pneumomediastinum, pneumothorax and retropneumoperitoneum in a cat presenting with dyspnoea and signs of cardiac tamponade secondary to metastatic pulmonary carcinoma. Spontaneous pneumopericardium is an extremely uncommon condition consisting of pericardial gas in the absence of iatrogenic/traumatic causes. In humans, it has been described secondary to pneumonia or lung abscess and very rarely secondary to pulmonary neoplasia.
Assuntos
Doenças do Gato/patologia , Neoplasias Pulmonares/veterinária , Enfisema Mediastínico/veterinária , Pneumopericárdio/veterinária , Pneumotórax/veterinária , Retropneumoperitônio/veterinária , Animais , Gatos , Feminino , Neoplasias Pulmonares/complicações , Neoplasias Pulmonares/patologia , Enfisema Mediastínico/etiologia , Enfisema Mediastínico/patologia , Pneumopericárdio/etiologia , Pneumopericárdio/patologia , Pneumotórax/etiologia , Pneumotórax/patologia , Retropneumoperitônio/etiologia , Retropneumoperitônio/patologia , Tomografia Computadorizada por Raios X/veterináriaRESUMO
Pneumomediastinum with subcutaneous emphysema is a rarely observed complication of dental treatment. It is a potentially dangerous condition, but the majority of cases are self-limiting and benign. We present a case of pneumomediastinum and cervicofacial emphysema that occurred after dental treatment. The rapid onset of swelling and dyspnoea are often misinterpreted as an allergic reaction to the anaesthesia used during the procedure. Physicians and dentists should be aware that cervicofacial emphysema can cause swelling after dental procedures and may mimic an allergic reaction.