An International Journal of Otorhinolaryngology Clinics

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VOLUME 7 , ISSUE 2 ( May-August, 2015 ) > List of Articles

CASE REPORT

An Interesting Case of Spontaneous Pneumomediastinum with Subcutaneous Emphysema following Oral Provocative Manoeuvre

CB Pratibha, Deepthi Satish, Suraj Gopal

Keywords : Emphysema,Laryngeal edema,Spontaneous pneumomediastinum

Citation Information : Pratibha C, Satish D, Gopal S. An Interesting Case of Spontaneous Pneumomediastinum with Subcutaneous Emphysema following Oral Provocative Manoeuvre. Int J Otorhinolaryngol Clin 2015; 7 (2):93-96.

DOI: 10.5005/jp-journals-10003-1200

Published Online: 00-08-2015

Copyright Statement:  Copyright © 2015; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Aim

To discuss a case of spontaneous pneumomediastinum with pneumothorax with subcutaneous emphysema presenting with stridor due to laryngeal edema with relevant review of literature.

Background

Spontaneous pneumomediastinum is a rare condition that has been described in healthy individuals following Valsalva manoeuvre, excessive and prolonged cough or emesis. Laryngeal involvement in these cases has not been reported so far.

Case description

We present an interesting case of spontaneous pneumomediastinum with pneumothorax with pneumopericardium and cervicofacial emphysema with suspected ingestion of foreign body. In view of stridor due to laryngeal edema tracheostomy was done. No obvious cause for the air leak was found on further investigations. The foreign body sensation could have led to oral provocative manoeuvres by the patient causing increased intra-alveolar pressures and air leak.

Conclusion

Spontaneous pneumomediastinum with cervicofacial emphysema with pneumopericardium with laryngeal involvement is very rare. Tracheostomy is essential in case of airway compromise. A thorough evaluation for the underlying condition is essential to prevent further air leak.

Clinical significance

In a case of spontaneous pneumomediastinum with airway compromise due to involvement of the larynx, tracheostomy is essential to secure the airway and could also help in resolution of emphysema.

How to cite this article

Pratibha CB, Satish D, Gopal S, Balasubramanya AM. An Interesting Case of Spontaneous Pneumomediastinum with Subcutaneous Emphysema following Oral Provocative Manoeuvre. Int J Otorhinolaryngol Clin 2015;7(2):93-96.


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  1. Spontaneous pneumomediastinum revisited. Respir Med CME 2011;4(4)181–183.
  2. Subcutaneous emphysema secondary to pulmonary cavity in absence of pneumothorax or pneumomediastinum. Respir Med 2007 Feb;101(2):363–365.
  3. The Mediastinum including the pericardium. In: Adam A, Dixon AK, Gillard JH, et al, editors. Grainger's and Allison's diagnostic radiology. 6th ed. Churchill Livingstone, Elsevier; 2015. p. 209–246.
  4. Cervical emphysema, pneumomediastinum, and pneumothorax following selfinduced oral injury. Chest 2001;120(1):306–309.
  5. Suwelack B. Spontaneous pneumopericardium due to exertion. South Med J 2003;96(1):1–3.
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