Olgu Sunumu
BibTex RIS Kaynak Göster

Anjiyoödem Sanılan Pnömomediastinum: Olgu Sunumu

Yıl 2024, , 391 - 395, 14.10.2024
https://doi.org/10.52827/hititmedj.1479321

Öz

Pnömomediastinum ve masif subkutan amfizem baş ve boyun ameliyatları, bronkoskopi ve trakeostomi gibi girişimler sırasında, toraks travması sonrasında, nadiren dental işlemler sırasında ve bazen de spontan olarak ortaya çıkabilen klinik durumlardır. Hastalar sıklıkla yüz, boyun ve bazen tüm vücutta şişlik, yutma güçlüğü, nefes darlığı, göğüs ağrısı ve ciltte krepitus gibi semptomlarla başvururlar. Bu bulgular genellikle aniden gelişir ve bazen saatler veya günler içinde ortaya çıkabilir. 48 yaşında erkek hasta bahçede düşmeye bağlı göğüs kafesinde ağrı şikâyeti ile hastaneye başvurur. Çekilen röntgen sonucunda herhangi bir patoloji olmadığı düşünülen hastaya ağrı kesici olarak ibuprofen reçete edilir ve taburcu edilir. İbuprofen aldıktan sonra anjiyoödem kliniği ile başvuran hastada pnömomediastinum olduğu tespit edilir. Vakada bahsedilen ve ilk etapta anjioödem düşünülen durumlarda dudakların şişmediğinin görülmesi ve cilt altı krepitasyonunun hissedilmesi, yani hastanın sadece inspeksiyon ve palpasyonla muayene edilmesi bile birkaç saniye içinde klinisyeni anjioödemden uzaklaştırıp doğru tanıya yönelmesini ve pnömomediastinum yönünde tetkikler yapmasını sağlar.

Kaynakça

  • Yılmaz F, Zortuk Ö. Subcutaneous Emphysema, Pneumomediastinum and Spinal Epidural Emphysema As Complications of Violent Coughing: A Case Report. Acta Biomed 2021; 30;92
  • Özhasenekler A, Gökhan Ş, Yılmaz F, Taş M, Tan Ö, Nasır A. Pneumomediastinum and Pneumothorax After Blunt Neck Trauma. Academic Journal of Emergency Medicine Case Reports 2010; 1: 17-19
  • Aslaner MA, Kasap GN, Demir C, Akkaş M, Aksu NM. Occurrence of pneumomediastinum due to dental procedures. The American Journal of Emergency Medicine 2014; 33, 125-e1.
  • Mishra L, Patnaik S, Patro S, Debnath N, Mishra S. Iatrogenic subcutaneous emphysema of endodontic origin–case report with literature review. Journal of clinical and diagnostic research 2014; JCDR, 8, 279.
  • Bernstein JA, Cremonesi P, Hoffmann TK, Hollingsworth J. Angioedema in the emergency department: a practical guide to differential diagnosis and management. International journal of emergency medicine 2017; 10, 1-11.4.
  • Dhawan AK, Archana S, Bisherwal K, Pandhi D. Subcutaneous emphysema mimicking angioedema. Indian dermatology online journal 2016; 7.1: 55-56.
  • Perna V, Vilà E, Guelbenzu JJ, Amat I. Pneumomediastinum: is this really a benign entity? When it can be considered as spontaneous? Our experience in 47 adult patients. European journal of cardio-thoracic surgery 2010; 37, 573-575.
  • Gambichler T, Schacht R, Noldes K, Boms S. A 63-Year-Old Female Presenting to the Emergency Department with Massive Facial Swelling and Dyspnea. Dermato 2023; 3, 158-160.

Pneumomediastinum Mistaken as Angioedema: Case Report

Yıl 2024, , 391 - 395, 14.10.2024
https://doi.org/10.52827/hititmedj.1479321

Öz

Pneumomediastinum and massive subcutaneous emphysema are clinical conditions that can occur during head and neck surgeries, bronchoscopy and tracheostomy, after thoracic trauma, rarely during dental procedures and sometimes spontaneously. Patients often present with symptoms such as swelling of the face, neck and sometimes the whole body, difficulty swallowing, shortness of breath, chest pain and skin crepitus. These findings usually develop suddenly and sometimes may occur within hours or days. A 48-year-old man is applies to the hospital with complaint chest pain due to a fall in the garden. If no pathology is thought to be present as a result of the X-ray, the patient is prescribed ibuprofen for pain relief and discharged. Patient who presents with what appears to be angioedema after taking ibuprofen is found to have pneumomediastinum. In the cases mentioned in the report and initially thought to be angioedema, seeing that the lips are not swollen and feeling subcutaneous crepitation, i.e. even just inspecting and palpating the patient, will distract the clinician from angioedema in a few seconds and direct him/her to the correct diagnosis and perform examinations in the direction of pneumomediastinum.

Kaynakça

  • Yılmaz F, Zortuk Ö. Subcutaneous Emphysema, Pneumomediastinum and Spinal Epidural Emphysema As Complications of Violent Coughing: A Case Report. Acta Biomed 2021; 30;92
  • Özhasenekler A, Gökhan Ş, Yılmaz F, Taş M, Tan Ö, Nasır A. Pneumomediastinum and Pneumothorax After Blunt Neck Trauma. Academic Journal of Emergency Medicine Case Reports 2010; 1: 17-19
  • Aslaner MA, Kasap GN, Demir C, Akkaş M, Aksu NM. Occurrence of pneumomediastinum due to dental procedures. The American Journal of Emergency Medicine 2014; 33, 125-e1.
  • Mishra L, Patnaik S, Patro S, Debnath N, Mishra S. Iatrogenic subcutaneous emphysema of endodontic origin–case report with literature review. Journal of clinical and diagnostic research 2014; JCDR, 8, 279.
  • Bernstein JA, Cremonesi P, Hoffmann TK, Hollingsworth J. Angioedema in the emergency department: a practical guide to differential diagnosis and management. International journal of emergency medicine 2017; 10, 1-11.4.
  • Dhawan AK, Archana S, Bisherwal K, Pandhi D. Subcutaneous emphysema mimicking angioedema. Indian dermatology online journal 2016; 7.1: 55-56.
  • Perna V, Vilà E, Guelbenzu JJ, Amat I. Pneumomediastinum: is this really a benign entity? When it can be considered as spontaneous? Our experience in 47 adult patients. European journal of cardio-thoracic surgery 2010; 37, 573-575.
  • Gambichler T, Schacht R, Noldes K, Boms S. A 63-Year-Old Female Presenting to the Emergency Department with Massive Facial Swelling and Dyspnea. Dermato 2023; 3, 158-160.
Toplam 8 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Acil Tıp
Bölüm Olgu Sunumu
Yazarlar

Yusuf Kantar 0000-0001-8358-5312

Yayımlanma Tarihi 14 Ekim 2024
Gönderilme Tarihi 6 Mayıs 2024
Kabul Tarihi 1 Ağustos 2024
Yayımlandığı Sayı Yıl 2024

Kaynak Göster

AMA Kantar Y. Pneumomediastinum Mistaken as Angioedema: Case Report. Hitit Medical Journal. Ekim 2024;6(3):391-395. doi:10.52827/hititmedj.1479321