Unrecognized Pneumothorax As a Cause of Intraspinal Air

Khodadadyan, C; Hoffmann, Reinhard; Neumann, Karoline T.; Südkamp, Norbert P.

doi:10.1097/00007632-199504000-00019

Cited by 19 publications

(17 citation statements)

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“…Several reports of fracture-dislocations in the thoracic spine without associated spinal cord injury have been published [4,5]. Two recent papers reported on the presence of air in the spinal canal in conjunction with thoracic trauma [2,3]. Laceration of bronchus with clinical significance resulting from anterior displacement of the spiculae of a thoracic vertebral body fracture, to our knowledge, has not been previously reported.…”

Section: Discussionmentioning

confidence: 95%

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Unrecognized laceration of main bronchus caused by fracture of the T6 vertebra

Korovessis

Stamatakis²,

Baikousis³

1998

European Spine Journal

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IntroductionSpinal trauma frequently results from high-energy vehicular accidents, which may produce multisystem trauma [2][3][4][5]7]. Because of the priorities of resuscitation, other injuries may escape early diagnosis. This study reports on an extremely rare case of laceration of the bronchus by fragments of a bursting vertebral fracture that was not diagnosed on admission. Case reportA 58-year-old man riding a motorcycle was hit by a car. On admission, the patient was in an excellent general condition, without cardiovascular or respiratory complaints. Physical examination revealed displaced ankle fractures bilaterally and a displaced olecranon fracture on the left. Lateral roentgenograms of the spine revealed a fracture of the T6 vertebra, while the CT scan revealed a bursting of its vertebral body (Fig. 1). Lung sounds and respiratory airway pressures were normal and the roentgenograms of the thorax in supine position were within normal limits; in particular, no hemothorax or pneumothorax was found. Ultrasound scanning of the abdomen (to examine the liver and spleen parenchyma and check for bleeding) [1] revealed no pathological findings in the abdominal cavity or retroperitoneal space. The neurologic examination showed regular intrinsic muscle reflexes, both motor and sensory, in the upper and lower extremities. Two days after admission it was planned to stabilize the ankle and olecranon fractures under general anesthesia. The patient was placed in supine position for introduction of the general anesthesia. Immediately after introduction of the endotracheal tube and application of positive pressure by the anesthetist, a curious sound was observed inside the chest, which was followed by an increasing distention of the abdomen, without reverse filling of the ventilation balloon during the passive expiration. In other words, the volume of air passively inspirated through the tube was not followed by the passive expiration of an equal air volume. There appeared to be a significant concentration of the mechanically inspirated air somewhere inside the body. Initially it was supposed that the tube was not correctly positioned in the trachea. Thus, although the anesthetist performed repeated intubations in order to secure absolutely correct intubation (avoiding the esophagus, ensuring good contact of the tube on the inner surface of the trachea, etc.), the result was always the same. An increasing distention of the abdomen was observed during ventilation of the lungs with positive pressure, whereas when the tube was removed the distention decreased in a few seconds. Repeated blood gas analyses showed normal saturation and base levels, and the PO 2 , PCO 2 , and PH values were within normal limits for the age, height, and sex of the patient. Further anteroposterior and lateral chest roentgenograms in supine position on the operation table AbstractWe report on an extremely rare case of a 58-year-old male polytraumatized patient who sustained a bursting fracture of the T 6 vertebral body associated with laceration o...

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Section: Discussionmentioning

confidence: 95%

“…Spinal trauma frequently results from high-energy vehicular accidents, which may produce multisystem trauma [2][3][4][5]7]. Because of the priorities of resuscitation, other injuries may escape early diagnosis.…”

Section: Introductionmentioning

confidence: 99%

Unrecognized laceration of main bronchus caused by fracture of the T6 vertebra

Korovessis

Stamatakis²,

Baikousis³

1998

European Spine Journal

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“…PR being secondary to trauma is rare and it may contain isolated head trauma [9], cervical trauma [10], thoracic trauma [11], abdominal trauma [1], and pelvic trauma [12] or spinal trauma in several combinations [13]. Epidural PR may be seen being secondary to traumatic pneumothorax [14]. A fistula occurring between the dura and pleura as a result of the penetrating injury in the thoracic vertebra fractures may the cause of epidural PR [15].…”

Section: Discussionmentioning

confidence: 99%

Pediatric Traumatic Pneumorrhachis: Case Report

et al. 2019

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The existence of air in the spinal canal is referred to as pneumorrhachis. It is classified as extradural (epidural) or intradural (subdural or subarachnoid) according to the location where it is found. Nontraumatic, traumatic, and iatrogenic causes have been attributed to its occurrence. Traumatic pneumorrhachis is very rare and rarely seen in children. In our article, a 16-year-old male child in which air formation within the spinal canal was detected after an injury by a penetrating and cutting (knife) tool is discussed. Observing air within the spinal canal due to traumatic causes is an important situation rarely seen in the pediatric age group. In general, this situation, which can be seen after multiple trauma, may be encountered following a minor trauma. The correct assessment of the radiologic imaging methods ensures not to miss the manifestation of the disease.

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“…Patients who sustain blunt chest trauma may develop pneumothorax and associated intraspinal gas. 11,14,15 The gastrointestinal tract is another potential site of origin, as intraspinal gas can be related to intestinal necrosis. This breakdown of tissue can cause extensive gas accumulation in the portal and mesenteric veins, and within the intestinal wall itself.…”

Section: Discussionmentioning

confidence: 99%

Intraspinal gas

Konya

Özgen

Sun

et al. 2007

Journal of Clinical Neuroscience

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Intraspinal gas can be observed in a number of pathological settings including degenerative disc disease, infection, tumor or trauma, and in patients who have undergone therapeutic and diagnostic procedures. The air can be epidural, intradural or intradiscal. Intraspinal gas is usually asymptomatic. We report intraspinal gas in three patients, one with cervical, one with thoracic, and one with lumber disc disease and spondylolisthesis. The investigations were all completed at the the same medical center and CT and MRI were done in each case. The gas was in the epidural space in all three patients. These cases provide further evidence that intraspinal gas may persist without causing symptoms, and that resultant symptoms can disappear spontaneously. MRI is not reliable for diagnosing intraspinal gas; CT is recommended.

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Unrecognized Pneumothorax As a Cause of Intraspinal Air

Cited by 19 publications

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Unrecognized laceration of main bronchus caused by fracture of the T6 vertebra

Unrecognized laceration of main bronchus caused by fracture of the T6 vertebra

Pediatric Traumatic Pneumorrhachis: Case Report

Intraspinal gas

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