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

Mediastinal emphysema is a rare but known complication of deep-space infection or maxillofacial trauma. In this case report, a healthy 17-year-old girl experienced chest pain on the third day after a Le Fort I maxillary osteotomy. An film x-ray of the chest showed air in the mediastinum. A discussion of the potential causes and management of this complication are presented.
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PMID:Mediastinal emphysema following Le Fort I osteotomy: report of a case. 346 23

A 25-year-old man was admitted with severe chest pain and an electrocardiogram suggestive of anterior myocardial infarction. Echocardiogram was normal, but chest X-ray showed left-sided pneumothorax. The electrocardiogram showed increasing R-wave amplitude in the days after correction of pneumothorax. Taken in the supine position the electrocardiogram can be misleading in case of pneumothorax or mediastinal emphysema, but the electrocardiogram should be normal if taken in the erect position.
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PMID:Electrocardiographic changes in spontaneous left pneumothorax. 360 60

The presentation, diagnosis and management of 14 cases of spontaneous transmural oesophageal rupture have been reviewed. Analysis suggested that the classical triad of vomiting, chest pain and subcutaneous emphysema was rare (1/14) and therefore misleading. Abdominal pain and tenderness obscured the clinical picture; the temporal relationship of pain to vomiting varied and subcutaneous emphysema was uncommon (4/14). Consequently, only two cases were correctly diagnosed on presentation and diagnosis in the others was markedly delayed (average 4 days). Contrast swallow examination, when eventually performed, was diagnostic. Twelve patients underwent repair: four under 24 h, who all survived and eight over 24 h, amongst whom there were one (12.5 per cent) operative and two (25 per cent) late deaths. Conservative management was successful in the remaining two cases. Oesophageal fistula, empyema and incorrect initial surgery were common and serious complications. Management options are reviewed and their relative merits considered.
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PMID:Diagnosis and management of spontaneous transmural rupture of the oesophagus (Boerhaave's syndrome). 397 78

Eighty patients with spontaneous pneumothoraces treated in the University Department of Medicine, Singapore General Hospital from January 1981 to March 1983 were reviewed. There were 75 males and 5 females. Their ages ranged from 15 to 92 years. Dyspnea was the chief representing symptom in 59 patients (74%) followed by chest pain in 47 patients (59%). One patient was admitted with loss of consciousness. Pneumothorax with no discernable associated disease was present in 36 patients (45%) whereas 34 (43%) had chronic obstructive airways disease. Of the remaining 10 patients, active pulmonary tuberculosis was present in 5, bronchogenic carcinoma in 2, bronchial asthma in 2 and bronchopneumonia in 1 percent. Pneumothorax occurred equally on both sides. Single episode of pneumothorax was present in 64 patients (80%). Recurrent pneumothoraces were only present in 16 patients (20%). 57 patients (71%) required chest tube insertion while 14 patients (18%) in addition required either medical or surgical pleurodesis. Death occurred in 6 patients (7.5%) mainly in those with chronic obstructive airways disease. In this study the majority of pneumothoraces occurred in patients with either no underlying pulmonary disease or those with chronic obstructive bronchitis and emphysema. A bimodal age presentation was noted, with the younger patients having no underlying respiratory disorders.
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PMID:Spontaneous pneumothorax in medical practice in a general hospital. 407 13

An unusual case of spontaneous rupture of the esophagus (Boerhaave syndrome) presented initially with only unilateral proptosis secondary to orbital emphysema, without significant chest or abdominal symptoms. The classical signs of chest pain and cardiovascular collapse were absent. The diagnosis was suggested by the presence of mediastinal emphysema on chest roentgenogram. Boerhaave syndrome was seen after a barium swallow, and the patient was taken immediately to surgery and he survived without further complications. The presence of subcutaneous or mediastinal emphysema with or without other classical signs or symptoms should prompt an aggressive search for its origin. Because a decrease in mortality and morbidity occurs with early detection of this syndrome, a brief review of common and uncommon symptoms is presented.
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PMID:Spontaneous rupture of the esophagus presenting with unilateral proptosis. 671 38

A policy of obtaining a routine chest radiograph in every young patient with unexplained chest pain or dyspnoea led to the diagnosis of 14 cases of spontaneous pneumomediastinum within four years, whereas only two cases from former years could be found retrospectively. One patient had recurrent spontaneous pneumomediastinum, the first case so far reported. Analysis of admission data suggested that this entity may be much more common than is generally believed, and may be second only to spontaneous pneumothorax as a cause of admission of young, healthy individuals experiencing sudden chest pain or shortness of breath. After reviewing the published reports we propose the following definition of spontaneous mediastinal emphysema: the non-traumatic presence of free air in the mediastinum in a patient with no known underlying lung disease. When it occurs without associated pneumothorax it is benign. The incidence of spontaneous pneumomediastinum for the four-year period under study was 1 per 12 850 admissions.
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PMID:Spontaneous pneumomediastinum: is it a rare cause of chest pain? 687 88

A case of spontaneous pneumothorax occurring at the end of labour in a healthy 17-year-old primigravida is described. Its occurrence was accompanied by marked surgical emphysema of the face, neck, arms and thorax. The patient had had previous thyroid surgery and was coincidentally found to have bilateral cervical ribs on chest X-ray. Previously described cases are reviewed, and the management discussed. Hypoxia to the fetus is a definite threat, and spontaneous pneumothorax should be considered in the differential diagnosis of chest pain and dyspnoea during delivery. It is a potential extragenital cause of maternal mortality.
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PMID:Spontaneous pneumothorax in pregnancy and labour. 717 Feb 72

A young woman presented with left sided chest pain. Chest radiography revealed a hyperexpanded left upper lobe and the rare diagnosis of congenital lobar emphysema was made. She was then found to be pregnant. Thoracotomy and left upper lobectomy were performed during the pregnancy without adverse effects to the mother or fetus. The implications of pregnancy on the surgical management of this rare condition are discussed.
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PMID:Adult congenital lobar emphysema in pregnancy. 757 Apr 48

We have surgically treated six patients with bronchial rupture caused by blunt chest injury in the past 5 years. All injuries resulted from traffic accidents, except in one patient who was hit by a crane. Clinical manifestations included chest pain (n = 6), subcutaneous emphysema (n = 4), and dyspnea (n = 6). Roentgenographic findings were tension (n = 3) or nontension (n = 3) pneumothorax, subcutaneous emphysema (n = 4), pneumomediastinum (n = 3), deep cervical emphysema (n = 5), and delayed collapse of the affected lung (n = 3). Three patients had associated injuries: right clavicle and rib fractures in the first; right humeral, scapular, and multiple rib fractures and left sternoclavicular joint dislocation in the second; and left clavicle fracture in the third. These six patients all underwent immediate tube thoracostomy and then bronchoplasty. Bronchoplasty was performed within 3 days in four patients and on days 16 and 30, respectively, in the other two patients. The affected lung demonstrated full expansion in all patients immediately after bronchoplasty. Follow-up bronchoscopy showed good patency of all bronchi.
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PMID:Bronchial rupture caused by blunt chest injury. 786 85

Pulmonary barotrauma (PB) is caused by expansion of gases in the respiratory system. We describe 22 cases in divers that constituted 10.2% of the accidents treated at the Spanish navy's hyperbaric center (1969-1990). Hemoptysis (27.2%), subcutaneous emphysema (22.7%) and chest pain (9.1%) were the most frequent thoracic-pulmonary signs. Changes in consciousness (54.5%) and motility (22.7%) were the main neurological symptoms. The highest indices of PB were recorded during training exercises in diving courses, with 91% of the trauma patients recuperating with no aftereffects thanks to prompt deep (50 m) recompression. Protocols for applying therapeutic tables are described, and the advantages of using tables for oxygen as opposed to air are discussed. Finally, we justify the need to have a hyperbaric chamber nearby for treating this type of accident.
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PMID:[The lung overexpansion syndrome as a diving accident. A review of 22 cases]. 774 71


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