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Query: UMLS:C0034067 (emphysema)
 11,506 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Giant pulmonary cyst is a rare clinico-pathological entity. It was described as a "windy tumor" by John Floyer in 1726. Since that time, there have been numerous reports on this unique manifestation of emphysema by many authors. In this report, we report one such interesting case who was diagnosed as tension pneumothorax.
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PMID:Giant pulmonary cyst simulating tension pneumothorax. 1146 70

A rare case of fatal tension pneumothorax is reported. An aged Japanese man with marked subcutaneous emphysema of the neck was found collapsed in a betting office. He was ascertained to have left tension pneumothorax, based on radiographic examinations carried out before his death. At autopsy, severe pneumomediastinum was observed, and the descending thoracic aorta with a ruptured dissecting aneurysm was closely adhered to the left lung pleura. The hemorrhage spread into the pulmonary parenchyma and finally spouted out from the surface of the lung apex. Because the blood loss itself was not fatal in quantity, it is concluded that the patient died of tension pneumothorax caused by a lung penetration from the rupture of an aortic aneurysm.
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PMID:Sudden death caused by tension pneumothorax after rupture of a thoracic aortic aneurysm. Case report. 1156 33

The most appropriate airway device for use in EMS systems staffed by basic skilled EMTs with (EMT-Ds) or without (EMT-Bs) defibrillation capabilities is still a matter of debate. The purpose of this study was to assess the feasibility, safety and effectiveness of the Esophageal Tracheal Combitube (ETC) when used by EMT-Ds in cardiorespiratory arrest patients of all etiologies. The EMTs had automatic external defibrillator (AED) training but no prior advanced airway technique skills. The prehospital intervention was reviewed using the EMTs cardiac arrest report, the AED tape recording of the event and the assessment of the receiving emergency physician. The patients' hospital records and autopsy report were reviewed in search of complications. Eight hundred and thirty-one adult cardiac arrest patients were studied. Placement was successful in 725 (95.4%) of the 760 patients where it was attempted and ventilation was successful in 695 (91.4%). Immediate complications encountered, but not necessarily related to the use of the ETC, were; subcutaneous emphysema (18), tension pneumothorax (5), blood in the oropharynx (15), and swelling of the pharynx (three). An autopsy was done in 133 patients; no esophageal lesions or significant injury to the airway structures were observed. Our results suggest that EMT-Ds can use the ETC for control of the airway and ventilation in cardiorespiratory arrest patients safely and effectively.
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PMID:Use of the esophageal tracheal combitube by basic emergency medical technicians. 1180 52

An 80-year old woman with a history of tracheal stenosis, tracheostomy, and 3 months of increasing respiratory distress underwent tracheal dilatation under general anesthesia with jet ventilation. Tracheal dilatation was successfully performed via suspension laryngoscopy and jet ventilation. During emergence the patient developed decreased oxygen saturation, hypotension, and respiratory distress, requiring intubation and ventilatory support. During tracheostomy, anterior chest subcutaneous emphysema led to a diagnosis of tension pneumothorax. Chest tube placement facilitated tracheostomy and improved ventilatory and circulatory parameters. This article discusses the diagnosis and treatment of a tension pneumothorax under general anesthesia. Jet ventilation, spontaneous rupture of blebs or bullae, surgical trauma, or barotrauma are the 4 most likely explanations for a tension pneumothorax in this patient. Jet ventilation can cause pneumothorax, pneumomediastinum, or subcutaneous emphysema. Chronic obstructive pulmonary disease may cause blebs or bullae, which might rupture when exposed to positive pressure ventilation. Tissue trauma during dilatation or tracheostomy may cause a pneumothorax when positive pressure ventilation is employed. Barotrauma from high peak inspiratory pressure, rigid bronchoscopy, dilatation procedure, or jet ventilation may cause a pneumothorax. Prompt diagnosis and treatment will markedly decrease associated morbidity and mortality.
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PMID:Diagnosis and treatment of tension pneumothorax under anesthesia: a case report. 1188 40

Tracheobronchial tree injuries occur in a small number of patients after blunt chest trauma, and their occurrence is uncommon in the pediatric trauma population. The authors report two male children, one with a tracheal rupture, and the other with disruption of the main right bronchus. Mediastinal and subcutaneous emphysema resulting in airway obstruction were noted in Case 1 and soft-tissue emphysema, pneumomediastinum and tension pneumothorax were evident in Case 2 at the time of presentation. In the child with bronchial disruption, a major airway injury was suspected early on, because of a massive air leak despite two properly placed chest tubes. The definitive diagnosis was established bronchoscopically, and thoracotomy and primary repair were performed. The child with rupture of the posterior tracheal wall was diagnosed at an early stage by bronchoscopy and he was successfully managed without surgery.
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PMID:Tracheobronchial rupture due to blunt trauma in children: report of two cases. 1254 97

Bronchial rupture is an uncommon injury that presents clinically and radiologically with tension or non-tension pneumothorax, pneumomediastinum and subcutaneous emphysema caused by air leak and migration of free gas. Infradiaphragmatic gas has previously been demonstrated in mechanically ventilated patients with pneumomediastinum and is secondary to passage of air via anterior and posterior trans-diaphragmatic pathways. We present a case of bronchial rupture complicated by extensive infradiaphragmatic gas following mechanical ventilation that illustrates these pathways and some of the major radiographic signs associated with this injury.
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PMID:Anterior infradiaphragmatic free gas following bronchial rupture: case report and literature review. 1502 22

Massive lobar emphysema in the middle lobe of the right lung was observed in a dog brought to our clinic with sudden onset of tension pneumothorax, and lobectomy was performed to excise it. Pathological examination resulted in a diagnosis of congenital bronchiectasis associated with bronchial cartilage hypoplasia. Two cases of diagnosis and successful treatment of congenital lobar emphysema have been reported in dogs.
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PMID:Surgical correction of congenital lobar emphysema in a dog. 1503 55

An 81-year-old man with an enhancing upper-pole renal mass underwent laparoscopic nephrectomy via a retroperitoneal approach. Postoperatively, his systolic blood pressure declined to 72 mm Hg, and arterial blood gas analysis suggested acute respiratory acidosis. Chest radiography suggested subcutaneous emphysema, but a CT scan showed tension pneumothorax. This case illustrates the difficulties in interpretation of chest films caused by the subcutaneous air that is routinely present after laparoscopic procedures.
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PMID:Pneumothorax masked by subcutaneous emphysema after laparoscopic nephrectomy. 1525 19

The preclinical tension pneumothorax which even without technical support is easily recognizable, requires immediate decompression. However, there are a number of patients with thoracic injuries such as serial rib fractures or palpable skin emphysema which--in combination with a ventilator--may necessitate the insertion of a thoracic tube. In the preclinical setting this procedure usually only takes place in the ventilated patient. With patients who are respiratorily compensated and are breathing spontaneously, careful control and a conservative approach is advised even if pneumothorax is suspected.
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PMID:[Invasive techniques in emergency medicine. II. Preclinical thorax drainage--indications and technique]. 1559 61

A 30-year-old man was admitted with chest trauma after a road traffic accident. The patient was paraplegic and suffered from transient monoparesia of the left arm. The chest X-ray revealed a severe right tension pneumothorax and thoracic spine fractures. Emergency right thoracic drainage was carried out followed by angiography. Unfortunately the patient died and an autopsy was not permitted. Consequently post-mortem multi-slice computed tomography (MSCT) was performed, revealing presence of air inside the right cerebral arteries, bilateral pneumothorax accompanied by a severe right tension pneumothorax, bilateral haematic pleural effusion, pneumomediastinum and bilateral lung contusions. Air was also observed within the right coronary artery, ascending aorta and right ventricle. Thoracic and cervical spinal epidural emphysema were diagnosed. Venous air embolism followed by arterial air embolism producing paradoxical embolism was diagnosed. To the best of our knowledge, this is the first case illustrating by post-mortem MSCT such simultaneous complications after chest trauma as spinal epidural emphysema and cerebral and coronary air embolism.
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PMID:Post-traumatic venous and systemic air embolism associated with spinal epidural emphysema: multi-slice computed tomography diagnosis. 1615 95


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