Statistics from Altmetric.com
Pneumorrhachis (PR)—the curious phenomenon of intraspinal air—is an exceptional radiographic finding. In this report the first case of PR of the entire spine is presented.
A 19 year old man with a history of diabetes mellitus and bronchial asthma was admitted because of cough, fever, nausea, and vomiting for 3 days. Physical examination and laboratory studies showed cervical subcutaneous emphysema, infection signs, and ketoacidotic decompensated diabetes mellitus with hyperglycaemia.
Subsequent computed tomography (CT) (fig 1) revealed pneumomediastinum, pneumoretroperitoneum, cervical and thoracic subcutaneous emphysema, external pneumocephalus, and PR of the entire spinal canal.
The patient underwent otorhinolaryngological exploration for presumptive diagnosis of nasopharyngeal abscess but no evidence of an infectious process was found.
With intravenous antibiotics for gastrointestinal infection and antibechic medication the symptoms resolved and the PR reabsorbed completely. The patient was discharged home asymptomatically after 12 days.
In this case, PR was secondary to tracheobronchial microinjury resulting from violent coughing. The air dissected from the upper respiratory tract into the paraspinal soft tissues of the neck, entered the spinal canal via the neural foramina, and extended epidurally throughout the entire vertebral canal (fig 1).
The current case serves to highlight the importance of PR as a rare and usually asymptomatic but eminent epiphenomenon of associated, frequently concealed, severe pathologies, so as to enable adequate patient management.
If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.