Presentation
We present a case of neonatal tracheal injury following delivery at term that presented with subcutaneous emphysema and pneumomediastinum before any attempt at intubation. The clinical course, treatment, and outcome are described. [ncbi.nlm.nih.gov]
Incomplete rupture may present late with bronchial stenosis, the lung eventually becoming atellectatic and collapsing beyond the complete obliteration which may occur. [ctsurgery.ukzn.ac.za]
Entire Body System
- Soft Tissue Swelling
Soft tissue swelling with crepitus was felt in the left supraclavicular area indicative of subcutaneous emphysema. Initial oxygen saturation was 87% on room air that improved to 100% within a few minutes. [nature.com]
Respiratoric
- Cough
Reference: coughing fit, fit of coughing, woop Reference information: zacenjivanje – whoop (kašljem) fit of coughing [Mićić S, Medicinski rečnik en-sr/sr-en] “Basic otorhinolaryngology: a step-by-step learning guide Autor: Rudolf Probst,Gerhard Grevers [proz.com]
We describe a case of tracheal injury where the patient developed subcutaneous emphysema while coughing in the recovery room. [svemedplus.kib.ki.se]
We guessed that the over-inflation of the cuff made the tracheal wall weak, and sudden movement of the tube during the vigorous coughing caused the tracheal injury. [anesthpain.com]
[…] causes Motor vehicle accident: extended neck impacts on steering wheel or dashboard "Clothes line injury", assaults/strangulation Penetrating trauma (usually stabbings or gunshot wounds) Clinical Features Respiratory distress Hoarseness, dysphonia, cough [wikem.org]
Bruising on the neck Coughing blood Neck swelling Laryngeal trauma as seen during an endoscopic exam If trauma to the larynx is suspected, the doctor will do a few things to confirm the diagnosis. [chop.edu]
- Stridor
Motor vehicle accident: extended neck impacts on steering wheel or dashboard "Clothes line injury", assaults/strangulation Penetrating trauma (usually stabbings or gunshot wounds) Clinical Features Respiratory distress Hoarseness, dysphonia, cough, stridor [wikem.org]
In mild croup, your child may have stridor only when crying or coughing. If croup gets worse, your child may also have stridor when relaxed or sleeping, and may have trouble breathing. [aboutkidshealth.ca]
Mild inspiratory stridor had been noted at home when she cried, and she had a slight hoarse cry. No baseline stridor was noted during the office examination. [nature.com]
Signs and symptoms of laryngeal trauma include: View this video with a transcript Difficulty speaking or making sounds Change in voice (hoarseness) Noisy breathing (stridor) Respiratory distress Complaints of neck pain or pain when swallowing or coughing [chop.edu]
Musculoskeletal
- Contusion
[…] dysphonia, cough, stridor, dysphagia Subcutaneous emphysema Cervical ecchymosis Hemoptysis Tracheal deviation or abnormal laryngeal contour Differential Diagnosis Thoracic Trauma Airway/Pulmonary Bronchial injury Diaphragm injury Hemothorax Pulmonary contusion [wikem.org]
Bronchoscopy revealed deformation of the cartilage crescent in the cervical trachea (suggestive of cartilage contusion) and a longitudinal tear in the membranous region. [ncbi.nlm.nih.gov]
The patient had multiple fractures of the left ribs, bilateral pneumothorax, left lung contusion, fracture of the sternum, and right open fracture of the fibula with contused wounds; he underwent tracheoplasty. [onlinelibrary.wiley.com]
Related posts: Cardiac Contusion—Myocardial Contusion A cardiac contusion is a complication of an injury such as are often sustained in a car accident. A myocardial contusion, also known as a cardiac cont... [noonanlawma.com]
Patients complicated with pulmonary contusion should be kept intubation with the support of ventilation. [jtd.amegroups.com]
Face, Head & Neck
- Subcutaneous Emphysema of the Neck
Vital signs were normal, and physical examination revealed subcutaneous emphysema in the neck. [atsjournals.org]
Figure 2: Supin chest radiograph showing pneumomediastinum and neck subcutaneous emphysema. Figure 3: (A) CT image of the neck showing subcutaneous emphysema and larygotracheal framework distortion. [academic.oup.com]
Physical examination showed the large subcutaneous emphysema in the neck, face and thoracic region. We performed a chest radiograph, which showed pneumomediastinum, subcutaneous emphysema and bilateral pneumonia. [journals.lww.com]
hemoptysis, subcutaneous emphysema in the neck, and pneumomediastinum; (3) significant worsening of dyspnea when the neck is extended; and (4) hoarseness. [sjtrem.biomedcentral.com]
On extubation the following day, the patient developed sudden shortness of breath, accompanied by widespread subcutaneous emphysema to the neck and face. He was immediately reintubated and a suspicion of tracheobronchial injury was raised. [clinmedjournals.org]
Workup
Clinical Testing and Workup A diagnosis of subglottic stenosis may be suspected based on the results of pulmonary function tests. [rarediseases.org]
Treatment
In patients with tracheal injuries, conservative treatment is an alternative approach when surgical treatment is difficult. [ncbi.nlm.nih.gov]
Treatment of tracheal injury Conservative treatment The simple airway mucosal tearing is always self-limited without any special treatment. [jtd.amegroups.com]
Prognosis
Prognosis and Long-Term Outlook Mortality from associated injuries in a penetrating injury to the neck can be as high as 50%; this is due to the close proximity of major blood vessels to the trachea. [pagelaw.com]
However, the prevalence of several risk factors for tinea cruris, such as obesity and diabetes mellitus, is rapidly increasing among adolescents. [4] Prognosis The prognosis of tinea cruris is excellent with appropriate diagnosis and treatment; however [emedicine.medscape.com]
While mortality decreased from 36% before 1950 to 9% in 2001, prognosis greatly depends on early detection, the presence of concomitant injuries, and the cause of the injury.[8][3] Blunt tracheal injuries were associated with a better prognosis than [ncbi.nlm.nih.gov]
Etiology
We identified clinical manifestations and treatments of complications associated with endotracheal tubes and codified them into International Classification of Disease-ninth revision diagnosis and procedure codes, intentionally excluding alternative etiologies [ncbi.nlm.nih.gov]
The etiologic agents in tinea cruris produce keratinases, which allow invasion of the cornified cell layer of the epidermis. The host immune response may prevent deeper invasion. [emedicine.medscape.com]
Iran. 61 Rashidian S...Zaini F 28681000 2015 48 Diagnosis directs treatment in fungal infections of the skin. 61 Panthagani AP...Tidman MJ 26738249 2015 49 Dermatophytosis in patients with human immunodeficiency virus infection: clinical aspects and etiologic [malacards.org]
Epidemiology
Rural-Based Tertiary Health Care Center. 61 Pariath K...Nair PA 31543529 2019 5 Prevalence and clinical characteristics of itch in epidemic-like scenario of dermatophytoses in India: a cross-sectional study. 61 Verma S...Szepietowski JC 31419346 2019 6 Epidemiology [malacards.org]
Airway trauma: a review on epidemiology, mechanisms of injury, diagnosis and treatment. J Cardiothorac Surg. 2014 Jun 30;9:117. [PMC free article: PMC4104740] [PubMed: 24980209] 9. Chu CP, Chen PP. [ncbi.nlm.nih.gov]
Epidemiology Frequency United States Dermatophytosis accounts for approximately 10-20% of all visits to dermatologists. [1] International Tinea cruris has a worldwide distribution but is found more commonly in hot humid climates. [2, 3] Sex Tinea cruris [emedicine.medscape.com]
Airway trauma: a review on epidemiology, mechanisms of injury, diagnosis and treatment. [cardiothoracicsurgery.biomedcentral.com]
Pathophysiology
Pathophysiology The most common etiologic agents for tinea cruris include Trichophyton rubrum and Epidermophyton floccosum; less commonly Trichophyton mentagrophytes and Trichophyton verrucosum are involved. [emedicine.medscape.com]
Chhabra A, Rudingwa P, Selvam PSR, (2013) Pathophysiology and management of Airway Trauma. Trends in Anaesthesia and Critical Care 3: 216. Hurford WE, Peralta R (2003) Management of tracheal trauma. pp: 17-R22. [omicsonline.org]
Mortality is relatively high in patients with acute trauma to the trachea with a reported 15% to 40% range depending on mechanism and classification.[4] Pathophysiology Tracheal disruption may involve tracheal cartilages (most commonly from direct, blunt [ncbi.nlm.nih.gov]
Prevention
You must act quickly to ensure airway patency, while preventing further injury in cases of spinal trauma. [blog.sscor.com]
The temper of the disc prevents any disc wrinkling from occurring during application. [buyhandh.com]
In two patients, tracheal stenosis prevented extubation and required further surgery; in these patients breathing and swallowing functions had recovered at 6 months. [sjtrem.biomedcentral.com]
Control any athlete's foot infection to prevent its spread to the groin. If you spend time in moist public areas, such as a gym shower, wearing sandals will help prevent athlete's foot. Dec. 14, 2018 Ely JW, et al. [mayoclinic.org]
The described surgical approaches are transcervical, transthoracic or median sternotomy. [18 ] The potential benefits of surgery are: 1) closure of the defect to facilitate effective ventilation, 2) prevent mediastinitis due to contamination from non [tropicalgastro.com]