Search results

Search:
in the keywords: pneumomediastinum

Sort By:

Limit search:

Spontaneous pneumothorax and pneumomediastinum - clinical onset of COVID-19 pneumonia: a case report.

100%

De Rosa R. C., Gallifuoco M., Angelone M., Saracco E., Romanelli A.

Critical Care Innovations

2021

vol. 4

issue 3

33-40

Typical radiological findings in patients with SARS-CoV-2 pneumonia consist of the presence of bilateral pulmonary opacities (both ground-glass attenuations and consolidations) with a peripheral or subpleural distribution, often involving the posterior regions of both lungs specifically. Although interstitial pneumonia represents the hallmark of COVID-19, the clinician should remember that sudden worsening gas exchange may have different aetiology. Pneumothorax and pneumomediastinum are well-known complications of invasive mechanical ventilation. However, since the beginning, the development of spontaneous pneumothorax and pneumomediastinum was reported in COVID-19 patients, without risk factors. The exact mechanism for the development of spontaneous pneumothorax and pneumomediastinum in COVID-19 patients is still unclear, and findings suggest that these clinical manifestations can be interpreted as an index of lung disease severity associated with complicated hospital courses, worst prognosis and increase in mortality rate. We report a case of a SARS-CoV-2 infected obese male patient, in quarantine and without risk factors, presenting to the emergency department for severe dyspnea due to COVID-19 pneumonia complicated by spontaneous pneumothorax and pneumomediastinum.

Typowe zmiany radiologiczne u pacjentów z zapaleniem płuc w przebiegu SARS-CoV-2 obejmują obecność obustronnego zmętnienia w płucach (zarówno efektu szkła matowego, jak i konsolidacji) o rozkładzie obwodowym lub podopłucnowym, często obejmując tylne obszary obu płuc. Chociaż śródmiąższowe zapalenie płuc stanowi znak rozpoznawczy w przypadku COVID-19 klinicysta powinien pamiętać, że nagłe pogorszenie wymiany gazowej może mieć inną etiologię. Odma opłucnowa i odma śródpiersia to dobrze znane powikłania inwazyjnej wentylacji mechanicznej. Jednakże, od początku donoszono o rozwoju samoistnej odmy opłucnowej i odmy śródpiersia u pacjentów z COVID-19 bez czynników ryzyka. Dokładny mechanizm rozwoju spontanicznej odmy opłucnowej i odmy śródpiersia u pacjentów z COVID-19 jest nadal niejasny, a wyniki sugerują, że te objawy kliniczne mogą być interpretowane jako wskaźnik ciężkości choroby płuc związany z powikłanymi przebiegami szpitalnymi, gorszym rokowaniem oraz wzrostem śmiertelności. Przedstawiamy przypadek otyłego pacjenta płci męskiej zakażonego SARS-CoV-2, w kwarantannie i bez czynników ryzyka, który zgłosił się na oddział ratunkowy z powodu ciężkiej duszności spowodowanej zapaleniem płuc wywołanym przez COVID-19 powikłanym spontaniczną odmą opłucnowa i odmą śródpiersia.

Chest pain caused by pneumomediastinum as the first symptom of sigmoid perforation – case report

100%

Khuat D., Julkowska A., Chamarczuk F., Flont A., Horbacka K.

Polish Journal of Surgery

2020

vol. 92(5)

57-59

Introduction: Chest pain is one of the most common symptoms with which patients report to the doctor. The reason for this is the fear of the sick, who often equate this symptom with dangerous diseases such as heart attack. The primary source of pain does not always have to be located within the chest. Colon perforation is a rare but possible complication of colonoscopy, which may result in free gas entering the mediastinum which is accompanied by chest pain. Case report: We present the case of a 78-year-old woman who reported to the hospital emergency department with chest pain, shortness of breath and abdominal pain. On the basis of imaging examinations, perforation of sigmoid affected by diverticulosis, complicated by pneumomediastinum and retroperitoneal emphysema, was suspected. The aforementioned ailments were caused by iatrogenic perforation of the sigmoid during diagnostic colonoscopy performed on an outpatient basis a few hours before reporting to the hospital. The patient was urgently qualified for laparotomy. Intraoperatively, perforation was confirmed at the rectosigmoid junction, which was the cause of retroperitoneal and pneumomediastinum with rightsided emphysema of the lateral neck region. No fluid or intestinal contents were found in the abdomen. The sigmoid colon and upper rectum were resected via double-stapled anastomosis performed between the descending colon and rectum. The patient was discharged home in good condition on the 7th postoperative day. Conclusions: Colonoscopy is a diagnostic and therapeutic procedure that is considered relatively safe, but also carries complications such as bleeding or perforation of the large intestine. Diverticular disease is a common condition which most often affects the sigmoid colon. In areas of the weakest resistance, diverticulum formation occurs as a result of increased intra-abdominal pressure, which is an additional risk factor for perforation during colonoscopy. It is important to remember the possible different clinical presentation of gastrointestinal perforation, which may also manifest as chest pain. With early detection and surgical treatment, life-threatening complications associated with the development of pneumothorax can be avoided.

Refine search results

1 Critical Care Innovations

1 Polish Journal of Surgery

1 2021

1 2019

1 Angelone M.

1 Chamarczuk F.

1 De Rosa R. C.

1 Flont A.

1 Gallifuoco M.

1 Horbacka K.

1 Julkowska A.

1 Khuat D.

1 Romanelli A.

1 Saracco E.

Search results

Spontaneous pneumothorax and pneumomediastinum - clinical onset of COVID-19 pneumonia: a case report.

Chest pain caused by pneumomediastinum as the first symptom of sigmoid perforation – case report