Air Within the Spinal Canal in Spontaneous Pneumomediastinum

Belotti, Eva A.; Rizzi, Mattia; Rodoni-Cassis, Paola; Ragazzi, Monica; Zanolari-Caledrerari, Maura; Bianchetti, Mario G.

doi:10.1378/chest.09-0514

Cited by 38 publications

(21 citation statements)

References 36 publications

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“…Belotti et al reported a 14-years-old female who presented with chest pain that is complicated with spontaneous pneumomediastinum and pneumorrhachis. 7 Pneumorrhachis can be seen in epidural anesthesia, epidural abscess, lumbar puncture, scalp or spinal injuries, and traumatic pneumothorax or pneumomediastinum. Rupture of peripheral pulmonary alveoli may be seen due to increased intrathoracic pressure.…”

Section: Discussionmentioning

confidence: 99%

A Surprising Outcome of a Patient with Psychosis: Progressive Emphysema Associated with Pneumorrhachis

Polat¹,

Akça²,

Tuygun³

et al. 2019

cayd

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Air can be detected in various anatomical regions during the course of several diseases. This accumulation of air is often seen as pneumothorax and subcutaneous emphysema. Rarely extraordinary regions such as skull base and spinal region can be involved. In the majority of the patients, it is caused by trauma, iatrogenic factors and Valsalva maneuver. Supportive treatment is generally sufficient. A 14-year-old boy with psychosis who developed extensive air in the scull base, the neck, the orbita, mediastinum, abdomen, retroperitoneum, spinal canal, scrotum and head of the femur was presented. In the course of psychiatric disorders, in the case of excessive shouting and self-harm as a result of squeezing the throat, beside subcutaneous emphysema, air existing in the various anatomical regions of the body should be kept in mind.

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Section: Discussionmentioning

confidence: 99%

A Surprising Outcome of a Patient with Psychosis: Progressive Emphysema Associated with Pneumorrhachis

Polat¹,

Akça²,

Tuygun³

et al. 2019

cayd

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“…To our knowledge, this is the 3rd case in the medical literature reporting pneumorrhachis after cocaine use. The etiology of pneumorrhachis includes trauma (skull or spine injury), medical procedures (epidural anesthesia, lumbar puncture, and surgery), epidural abscess, and malignancies [ 4 , 5 ]. It is found in combination with associated air distribution in other compartments and cavities of the body, particularly, in conjunction with pneumocephalus, pneumothorax, pneumomediastinum, pneumopericardium, or subcutaneous emphysema [ 6 ].…”

Section: Discussionmentioning

confidence: 99%

Subcutaneous Emphysema, Pneumomediastinum, and Pneumorrhachis after Cocaine Inhalation

Temrel¹,

Şener²,

İçme³

et al. 2015

Case Reports in Emergency Medicine

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Introduction. The most prominent complications of cocaine use are adverse effects in the cardiovascular and central nervous systems. Free air in the mediastinum and subcutaneous tissue may be observed less frequently, whereas free air in the spinal canal (pneumorrhachis) is a very rare complication of cocaine abuse. In this report we present a case of pneumorrhachis that developed after cocaine use. Case. A 28-year-old male patient was admitted to the emergency department with shortness of breath, chest pain, and swelling in the neck and face which started four hours after he had sniffed cocaine. On physical examination, subcutaneous crepitations were felt with palpation of the jaw, neck, and upper chest area. Diffuse subcutaneous emphysema, pneumomediastinum, and pneumorrhachis were detected in the computed tomography imaging. The patient was treated conservatively and discharged uneventfully. Discussion. Complications such as pneumothorax, pneumomediastinum, and pneumoperitoneum that are associated with cocaine use may be seen due to increased intrathoracic pressure. The air then may flow into the spinal canal resulting in pneumorrhachis. Emergency physicians should know the possible complications of cocaine use and be prepared for rare complications such as pneumorrhachis.

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“…A more recent review by BELLOTI et al [10] found 42 reports for 47 cases of spontaneous PM complicated by PR that were published between 1989 and 2009. The median age of occurrence was 18 yrs and there was a male predominance in the epidemiology.…”

Section: Discussionmentioning

confidence: 99%

Pneumomediastinum and pneumorrhachis: a lot of air about nothing?

Aujayeb

Worthy

2012

Breathe

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A never-smoking 22-year-old male with no past medical history presented to the emergency department with sudden onset of sharp central chest pain and right-sided neck discomfort. There was no history of trauma or bronchitis. There was no history of air travel, allergen exposure or illicit drug use. He had consumed alcohol the night before presentation but had not vomited.Clinically, he had right-sided subcutaneous emphysema but no signs of pneumothorax. His pulse was 82 beats per min, blood pressure was 134/76 mmHg and oxygen saturation was 98% on air. His blood tests revealed no abnormality. His blood alcohol level was not measured.HERMES syllabus link: module B.13.3 Task 1Interpret the chest radiograph ( fig. 1) Statement of interestNone declared.

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Air Within the Spinal Canal in Spontaneous Pneumomediastinum

Cited by 38 publications

References 36 publications

A Surprising Outcome of a Patient with Psychosis: Progressive Emphysema Associated with Pneumorrhachis

A Surprising Outcome of a Patient with Psychosis: Progressive Emphysema Associated with Pneumorrhachis

Subcutaneous Emphysema, Pneumomediastinum, and Pneumorrhachis after Cocaine Inhalation

Pneumomediastinum and pneumorrhachis: a lot of air about nothing?

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