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Spontaneous Retropharyngeal and Mediastinal Emphysema

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초록

A 14-year-old girl with no significant medical history presented at Emergency Department with sore throat and odynophagia after one episode of nonviolent coughing. She denied any respiratory distress, voice change, foreign body ingestion, retching, substance abuse, dental procedures, or trauma. She was afebrile with normal oxygen saturation and physical examination including the head and neck was unremarkable with the exception of bilateral neck crepitus without tenderness on palpation. Fiberoptic laryngoscopy revealed a patent laryngeal airway with normal vocal fold movement. Lateral neck X-ray demonstrated a linear air-column in the retropharyngeal space and computed tomography confirmed emphysema involving the retropharyngeal space and mediastinum with no evidence of fluid collection or abscess formation. Spontaneous retropharyngeal and mediastinal emphysema are clinical entities where free air is present within the confines of retropharyngeal space and mediastinum without obvious cause. It is benign and self-limited in nature and allows for conservative management. This case is presented with a review of literature.

Abstract

A 14-year-old girl with no significant medical history presented at Emergency Department with sore throat and odynophagia after one episode of nonviolent coughing. She denied any respiratory distress, voice change, foreign body ingestion, retching, substance abuse, dental procedures, or trauma. She was afebrile with normal oxygen saturation and physical examination including the head and neck was unremarkable with the exception of bilateral neck crepitus without tenderness on palpation. Fiberoptic laryngoscopy revealed a patent laryngeal airway with normal vocal fold movement. Lateral neck X-ray demonstrated a linear air-column in the retropharyngeal space and computed tomography confirmed emphysema involving the retropharyngeal space and mediastinum with no evidence of fluid collection or abscess formation. Spontaneous retropharyngeal and mediastinal emphysema are clinical entities where free air is present within the confines of retropharyngeal space and mediastinum without obvious cause. It is benign and self-limited in nature and allows for conservative management. This case is presented with a review of literature.

참고문헌 (7)

  1. Hamman L, "Spontaneous mediastinal emphysema", Bull Johns Hopkins Hosp, 64, pp.1~21 (1939)
  2. Macklin MT., "Malignant interstitial emphysema of the lungs and mediastinum as an important occult complication in many respiratory diseases and other conditions : an interpretation of the clinical literature in the light in the light of laboratory experiment", Medicine, 23(4), pp.281~358 (1944)
  3. Newcomb AE., "Spontaneous pneumomediastinum : a benign curiosity or a significant problem?", Chest, 128(5), pp.3298~3302 (2005)
  4. Smith JL 2nd., "Spontaneous pneumomediastinum presenting with retropharyngeal emphysema", Am J Otolaryngol, 25(4), pp.290~294 (2004)
  5. Skogvoll E., "Life-threatening upper airway obstruction in a child caused by retropharyngeal emphysema", Acta Anaesthesiol Scand, 45(3), pp.393~395 (2001)
  6. Lee CC., "Spontaneous retropharyngeal emphysema and pneumomediastinum presented with signs of acute upper airway obstruction", Am J Emerg Med, 23(3), pp.402~404 (2005)
  7. Brauer RB., "Boerhaave’s syndrome : analysis of the literature and report of 18 new cases", Dis Esophagus, 10(1), pp.64~68 (1997)

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