Spontaneous surgical emphysema in children

Manuscript type : Case Report | Article Date : 2015/07/26

  • Autors

    1. Karthikeyan Padmanabhan
    2. Pulimoottil Davis Thomas
  • Abstract

    A fourteen year old girl presented to the outpatient ENT department of a tertiary care centre with complaints of sudden onset of swelling over the neck and upper chest associated with pain and mild breathlessness, following an episode of violent coughing. Examination revealed surgical emphysema over the entire neck and upper chest with absent laryngeal crepitus. Patient was also found to have signs suggestive of chronic pharyngotonsillitis. Auscultation of the chest revealed bilateral wheeze. Plain X-ray soft tissue neck (anteroposterior and lateral views) showed evidence of air in the pre-sternal region, pre-vertebral region and soft tissues of neck, suggestive of subcutaneous emphysema. As the patient’s condition was stable and the patient was maintaining oxygen saturation at room air, the patient was managed conservatively with intravenous broad spectrum antibiotics, oral corticosteroids, bed rest and other supportive therapy. The patient improved within a week, with complete relief of all symptoms and full clinical resolution of the surgical emphysema. A review of the possible mechanism is presented. This case is being reported due to its rarity, as spontaneous tracheal rupture is extremely uncommon and has only very rarely been reported in the pediatric population.
  • Description

  • Reference