scholarly journals Pneumomediastinum in Blunt Chest Trauma: A Case Report and Review of the Literature

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Gregory Mansella ◽  
Roland Bingisser ◽  
Christian H. Nickel
Keyword(s):  
Case Report ◽  
Physical Examination ◽  
Blunt Chest Trauma ◽  
Chest Trauma ◽  
Common Mechanism ◽  
Cervical Trauma ◽  
X Ray ◽  
Retrosternal Pain ◽  
Chest X Ray ◽  
Bedside Diagnosis

Blunt trauma is the most common mechanism of injury in patients with pneumomediastinum and may occur in up to 10% of patients with severe blunt thoracic and cervical trauma. In this case report we present a 24-year-old man with pneumomediastinum due to blunt chest trauma after jumping from a bridge into a river. He complained of persistent retrosternal pain with exacerbation during deep inspiration. Physical examination showed only a slight tenderness of the sternum and the extended Focused Assessment with Sonography for Trauma (e-FAST) was normal. Pneumomediastinum was suspected by chest X-ray and confirmed by computed tomography, which showed a lung contusion as probable cause of the pneumomediastinum due to the “Mackling effect.” Sonographic findings consistent with pneumomediastinum, like the “air gap” sign, are helpful for quick bedside diagnosis, but the diagnostic criteria are not yet as well established as for pneumothorax. This present case shows that despite minimal findings in physical examination and a normal e-FAST a pneumomediastinum is still possible in a patient with chest pain after blunt chest trauma. Therefore, pneumomediastinum should always be considered to prevent missing major aerodigestive injuries, which can be associated with a high mortality rate.

DIAGNOSTIC ACCURACY OF CHEST X-RAY IN THE DETECTION OF PNEUMOTHORAX IN BLUNT CHEST TRAUMA PATIENTS WITH CT AS THE GOLD STANDARD

2021 ◽  
Vol 5 (7) ◽  
Author(s):  
Danquale Vance Kynshikhar ◽  
Chaman Lal Kaushal ◽  
Ashwani Tomar ◽  
Neeti Aggarwal
Keyword(s):  
Diagnostic Accuracy ◽  
Predictive Value ◽  
Gold Standard ◽  
Blunt Chest Trauma ◽  
Chest Trauma ◽  
Trauma Patients ◽  
Care Level ◽  
X Ray ◽  
Primary Health ◽  
Chest X Ray

Background: To study the diagnostic accuracy of chest X-ray in the detection of pneumothorax in blunt chest trauma patients with CT as the Gold Standard Methods: The present study was conducted from 31th July 2018 to 30th July 2019. A total of 36 patients were enrolled in the study. Results: On Chest X-Ray Supine AP view, pneumothorax was detected in 11 of 24 patients. The sensitivity of Chest X-Ray Supine AP view was 45.83%, specificity was 100%, positive predictive value (PPV) was 100%, negative predictive value (NPV) was 48% and accuracy was 63.89% for the diagnosis of pneumothorax. Conclusion: A Chest radiograph is the most preferred and relevant primary investigation in the diagnosis of pneumothorax even with the various advanced techniques that are available. X-ray being relatively cheaper and is easily available even at the peripheral centers at the primary health care level. Keywords: X-ray, CT, Pneumothorax

scholarly journals Solitary Pulmonary Hematoma Radiographically Indistinguishable from Mediastinal Tumor

2020 ◽  
Vol 2020 ◽  
pp. 1-4
Author(s):  
Teruya Komatsu ◽  
Naoki Date ◽  
Takuji Fujinaga ◽  
Akira Hara ◽  
Tatsuo Kato
Keyword(s):  
Blunt Chest Trauma ◽  
Mediastinal Tumor ◽  
Chest Trauma ◽  
Callus Formation ◽  
Wedge Resection ◽  
Lower Lobe ◽  
X Ray ◽  
Pulmonary Tumor ◽  
Chest X Ray ◽  
Posterior Mediastinal

Solitary pulmonary hematoma is a rare consequence of blunt chest trauma. Moreover, there has been no reported case of solitary pulmonary hematoma radiographically diagnosed as a posterior mediastinal tumor. We present the case of a 63-year-old man who was referred for an oval-shaped opacity at the left paraspinal area on a chest X-ray. Chest computed tomography showed a well-circumscribed posterior mediastinal tumor on the left paraspinal lesion with extrapleural sign and callus formation on the left ribs posteriorly (7th to 11th ribs). The tumor was thoracoscopically confirmed to be a subpleural pulmonary tumor of the left lower lobe, and wedge resection was performed. Histological examination confirmed the diagnosis of pulmonary hematoma. On reviewing the callus formation of the ribs, which was suggestive of rib fractures, the pulmonary hematoma was determined to be traumatic in origin. The postoperative course was uneventful. We reviewed a rare case of pathologically proven traumatic solitary pulmonary hematoma. The rarity of this case is enhanced because the hematoma initially appeared to be a posterior mediastinal tumor.

scholarly journals Negative-pressure-related diffuse alveolar hemorrhage after monitored anesthesia care for vertebroplasty: a case report

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Yumin Jo ◽  
Jagyung Hwang ◽  
Jieun Lee ◽  
Hansol Kang ◽  
Boohwi Hong
Keyword(s):  
Case Report ◽  
Airway Obstruction ◽  
Negative Pressure ◽  
Diffuse Alveolar Hemorrhage ◽  
Alveolar Hemorrhage ◽  
Unknown Etiology ◽  
Anesthesia Care ◽  
Monitored Anesthesia Care ◽  
X Ray ◽  
Chest X Ray

Abstract Background Diffuse alveolar hemorrhage (DAH) is a rare, life-threatening condition that can present as a spectrum of nonspecific symptoms, ranging from cough, dyspnea, and hemoptysis to severe hypoxemic respiratory failure. Perioperative DAH is frequently caused by negative pressure pulmonary edema resulting from acute airway obstruction, such as laryngospasm, although hemorrhage itself is rare. Case presentation This case report describes an unexpected hemoptysis following monitored anesthesia care for vertebroplasty. A 68-year-old Asian woman, with a compression fracture of the third lumbar vertebra was admitted for vertebroplasty. There were no noticeable events during the procedure. After the procedure, the patient was transferred to the postanesthesia care unit (PACU), at which sudden hemoptysis occurred. The suspected airway obstruction may have developed during transfer or immediate arrive in PACU. In postoperative chest x-ray, newly formed perihilar consolidation observed in both lung fields. The patients was transferred to a tertiary medical institution for further evaluation. She diagnosed with DAH for hemoptysis, new pulmonary infiltrates on chest x-ray and anemia. The patient received supportive care and discharged without further events. Conclusions Short duration of airway obstruction may cause DAH, it should be considered in the differential diagnosis of postoperative hemoptysis of unknown etiology.

Chilaiditi Syndrome and Recurrent Colonic Volvulus: A Case Report

2001 ◽  
Vol 87 (2) ◽  
pp. 111-112
Author(s):  
Jon Matthews ◽  
Giles W Beck ◽  
Douglas M G Bowley ◽  
Andrew N Kingsnorth
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Case Report ◽  
Optimal Treatment ◽  
X Ray ◽  
Colonic Volvulus ◽  
Chilaiditi’S Syndrome ◽  
Chest X Ray ◽  
Chilaiditi’S Sign ◽  
Chilaiditi's Syndrome

AbstractThe case of a 31 year old male presenting as an emergency with a recurrent colonic volvulus is described. A chest X-ray on admission to hospital showed the presence of hepato-diaphragmatic interposition of the colon, Chilaiditi’s Sign, which is known to be a risk factor for colonic volvulus. This is only the fourth reported case of colonic volvulus in association with Chilaiditi’s Syndrome and the first with recurrent colonic volvulus. The optimal treatment for recurrent volvulus in patients with risk factors such as Chilaiditi’s Syndrome or megacolon is also discussed.

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