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Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành hóa học dành cho các bạn yêu hóa học tham khảo đề tài: Pneumothorax and subcutaneous emphysema secondary to blunt chest injury | P í ĩríDT A lĩí Journa of - Medicine 2011 4 10 International Journal of Emergency Medicine http www.intjem.com content 4 1 10 CASE REPORT Open Access Pneumothorax and subcutaneous emphysema secondary to blunt chest injury Jahan Porhomayon 1 Ralph Doerr2 Abstract This is the case of a patient with a history of blunt chest trauma associated with subcutaneous emphysema and pneumothorax. The patient complained of inspiratory stridor on presentation. Anatomical relationships can explain the pathophysiological process. Case report A 49-year-old male presented to the trauma service 10 h after blunt chest injury. Initial presentation included respiratory failure with a respiratory rate of 26 beats per minute a pulse rate of 110 beats per minute and blood pressure of 150 80 mmHg. He complained of dysphonia and facial swelling. Physical examination revealed inspiratory dyspnea and crepitations suggestive of subcutaneous emphysema of the face neck and upper portion of his chest. Pharyngeal examination revealed swollen mucosa with crepitations on palpation Figure 1a . Chest X-ray indicated extensive subcutaneous emphysema apparent in part as a group of muscles in the upper chest wall but with no obvious pneumothorax Figure 1c . Computed tomography of the chest confirmed subcutaneous and submucosal emphysema involving the pharynx. It also revealed obvious pneumomediastinum associated with left pneumothorax from rib fractures Figure 1b and 1d . Physical examination and bronchoscopy ruled out laryngotracheal mucosal rupture. The patient remained dyspneic after placement of a chest tube. Twenty-four hours later inspiratory dyspnea dysphonia and submucosal emphysema had resolved. Subcutaneous emphysema resolved in 4 days. The patient s recovery was uneventful. Figure 1 Subcuatneous and Submucosal emphysema. A Pharyngealsubmucosal emphysema B CT image with subcutaneous air C The chest radiograph shows extensive subcutaneous emphysema D The CT-scan shows pneumothorax .
