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

After single lung transplantation for emphysema native lung hyperinflation is a common complication that may cause respiratory failure. Herein we have reported satisfactory bronchoscopic lung volume reduction in a left single-lung transplant recipient with native lung hyperinflation, who suffered from Medical Research Council (MRC) class 3 dyspnea and chest pain. Three endobronchial valves (Zephyr; Emphasys Medical, Redwood, Calif, United States) were placed into the segmental bronchi of the right upper lobe, using videobronchoscopy under general anesthesia. Postoperative chest computed tomography revealed subsegmental atelectasis in that lobe. The clinical benefit was an improved MRC dyspnea class from 3 to 2, which was still present at 4 months after the procedure, although there were no remarkable changes in spirometric parameters.
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PMID:Bronchoscopic lung volume reduction in a single-lung transplant recipient with natal lung hyperinflation: a case report. 2062 May 61

We describe the case of an adolescent who was admitted to the hospital because of sudden occurrence of chest pain, dyspnea and subcutaneous emphysema. On admission, physical examination revealed subcutaneous crepitations in the superior part of the rib cage, and auscultation of the chest showed widespread wheezing. The radiological assessment confirmed the diagnosis of pneumomediastinum and pneumothorax. A follow-up CT scan performed one week after the admission showed almost complete resolution of the radiological alterations. At the following visits, the patient was asymptomatic, but reported to have suffered from frequent episodes of rhinorrea, sneezing, nasal blockage, and sometimes, chest tightness, especially during exposure to pets and/or windy weather. Skin prick testing showed sensitivities to dermatophagoides pteronyssinus and farinae, grass pollen and dog dander. Spirometry documented significant improvement in lung function after short-acting bronchodilator, allowing for the diagnosis of asthma to be made. Although pneumomediastinum may be a complication of various respiratory diseases, including asthma, it has never been reported as the first presentation of underlying bronchial asthma. Herein, the physiopathological mechanisms, the diagnostic procedures and treatment of pneumomediastinum in asthma are discussed. We suggest that the diagnosis of asthma should be considered in the differential diagnosis of pneumomediastinum in adolescence.
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PMID:A 15-year-old boy with anterior chest pain, progressive dyspnea, and subcutaneous emphysema of the neck. 2097 97

This case report refers to a 32-year-old primiparous woman with a mild asthma, who had a normal vaginal delivery in a birthing pool and developed an acute postpartum chest pain due to pneumomediastinum and subcutaneous chest emphysema. After 72 hours of observation, she was discharged home without any residual symptoms.
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PMID:Postpartum pneumomediastinum: an uncommon cause for chest pain. 2115 64

Subcutaneous emphysema and pneumomediastinum were first described by Hamman in 1945. Spontaneous pneumomediastinum is an uncommon, self-limiting condition caused by alveolar rupture and usually results from bronchial hyper-reactivity or barotraumas. We report a case describing a 25 year old patient in her first pregnancy, who during active labour developed subcutaneous emphysema and pneumomediastinum. Pneumomediastinum in labour is a rare complication to Valsalva maneuver, and it is diagnosed with a computed tomography. The most common symptoms are chest pain, dyspnea, neck pain and odynophagia.
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PMID:[Pneumomediastinum and subcutaneous emphysema complicating active labour]. 2198 38

We present a case of spontaneous pneumomediastinum (SPM) associated with sex. A 22-year-old lesbian with a history of asthma, cigarette and illicit drug smoking was diagnosed with a SPM after developing chest pain and dyspnoea in the context of performing oral sex. The main finding was subcutaneous emphysema involving the neck. SPM is an important differential diagnosis for chest pain in young people. It is a benign condition and diagnosis mainly limited to chest X-ray with increased incidence in asthmatics, smokers and drug addicts.
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PMID:Spontaneous pneumomediastinum associated with sex. 2247 Jul 23

A young, previously well primigravida presented a few hours after a short labour with sudden onset chest pain, shortness of breath and odynophagia. She had subcutaneous emphysema but did not have significant cardiorespiratory compromise. She was found to have a spontaneous pneumomediastinum, likely secondary to raised intrathoracic pressure during labour. Similar cases have been reported previously, however there are often risk factors associated such as pre-existing lung disease and illicit drug use for which this patient did not have a significant history. The patient made a speedy recovery without requiring invasive management, as is the case for most patients documented in the literature. Consideration should be given to subsequent labours for this patient to minimise excessive intrathoracic pressure, however recurrence is rarely documented. This case is useful for healthcare professionals in assessing patients with chest pain as a reminder that unusual presentations can be diagnosed through thorough history and examination.
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PMID:Spontaneous pneumomediastinum following normal labour. 2267 55

Spontaneous pneumomediastinum during labour is a rare, usually benign and self-limiting condition. It often presents with chest or neck pain and surgical emphysema. The latter sign is easy to demonstrate but often missed during clinical assessment if the condition is not included in the differential diagnosis of chest pain and dyspnoea in peripartum. The authors describe a case of 20-year-old primigravida who developed surgical emphysema following prolonged vaginal delivery. The chest x-ray revealed pneumomediastinum, and small left apical pneumothorax. She was investigated with CT of the chest and contrast swallow, both of which excluded oesophageal perforation. The management was conservative and she made a complete recovery. Spontaneous oesophageal rupture is a potential cause of pneumomediastinum and leads to high morbidity and mortality if not diagnosed early. However, it is extremely uncommon in labour, especially without a preceding history of vomiting. Unless a strong clinical suspicious exists, routine investigations and or treatment of suspected oesophageal perforation are unnecessary.
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PMID:Postpartum pneumomediastinum manifested by surgical emphysema. Should we always worry about underlying oesophageal rupture? 2268 38

A young, previously well primigravida presented a few hours after a short labour with sudden onset chest pain, shortness of breath and odynophagia. She had subcutaneous emphysema but did not have significant cardiorespiratory compromise. She was found to have a spontaneous pneumomediastinum, likely secondary to raised intrathoracic pressure during labour. Similar cases have been reported previously, however there are often risk factors associated such as pre-existing lung disease and illicit drug use for which this patient did not have a significant history. The patient made a speedy recovery without requiring invasive management, as is the case for most patients documented in the literature. Consideration should be given to subsequent labours for this patient to minimise excessive intrathoracic pressure, however recurrence is rarely documented. This case is useful for healthcare professionals in assessing patients with chest pain as a reminder that unusual presentations can be diagnosed through thorough history and examination.
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PMID:Spontaneous pneumomediastinum. 2269 9

We report a case of a 29-year-old woman who is known to have systemic lupus erythematosus and idiopathic interstitial pneumonia; she presented with a 1-day history of substernal chest pain and increasing shortness of breath. On examination, she was found breathless, but was not distressed or afebrile or normotensive. Auscultation of the heart revealed a positive Hamman's sign. There was chest-wall crepitus, and auscultation of the lung showed bilateral crepitations. Full blood count and biochemical profile were unremarkable. Chest x-ray showed signs of idiopathic interstitial pneumonia in addition to pneumomediastinum (linear band of air within mediastinal planes and continuous diaphragm sign) and chest-wall subcutaneous emphysema. She was treated with high-concentration oxygen. A repeat chest x-ray 5 days later showed complete resolution of the pneumomediastinum and subcutaneous emphysema, but signs of idiopathic interstitial pneumonia continued to persist.
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PMID:Spontaneous pneumomediastinum and subcutaneous emphysema in systemic lupus erythematosus. 2276 22

A 25-year-old woman with hirsutism presented to the Emergency Department of the medicine faculty in Gaziantep University with a 4-h History of dyspnoea, dysphagia, coughing, continuous and progressive chest pain radiating to the back and palpation of her neck. The physical examination was significant for diffuse neck and chest subcutaneous emphysema. The x-ray study and CT scan of the chest revealed pneumomediastinum. The patient reported that 6 h before presentation she took spironolactone due to hirsutism and she retched. Retching caused the symptoms. The patient was followed conservatively and fully recovered over the next 7 days. Spontaneous pneumomediastinum developed in this patient with no underlying lung disease, presumably from air leakage secondary to the excessive elevation of intrathoracic pressure due to retching. Pneumomediastinum is an uncommon disease arising most frequently and remains largely underdiagnosed clinically, especially in young, healthy patients.
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PMID:Pneumomediastinum after retching. 2306 Mar 71


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