Chest
Selected ReportsAn Unusual Case of Pneumorrhachis Following Resection of Lung Carcinoma
Section snippets
Case Report
A 60-year-old man received a diagnosis of left upper-lobe, large cell, undifferentiated carcinoma with chest wall invasion. He underwent a left upper-lobe lobectomy, en bloc chest wall resection, and resection of ribs 3 to 5 followed by 500-cGy external beam radiation therapy through anteroposterior and posteroanterior ports.
Three years later, after protracted severe coughing, this patient developed sudden-onset extensive subcutaneous emphysema in the head, neck, and chest. A chest radiograph
Discussion
In general, pneumorrhachis may enter the epidural space or may penetrate further into the subarachnoid space. Air that enters the epidural space usually does not migrate significantly, and complete resorption occurs spontaneously. Epidural space pneumorrhachis causes no symptoms or local pain. When pulmonary air enters the subarachnoid space, a bronchopleural-subarachnoid fistula is present, and air easily travels cephalad to the cranium (ie, pneumocephalus). These patients experience severe
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Cited by (33)
Pneumorachis and pneumocephalus: Case report of a rare blunt chest trauma complication
2022, Annals of Medicine and SurgeryCitation Excerpt :It can also be secondary to local gas production during epidural abscesses, which has been described in patients with diabetes or Crohn's disease [9]. Another non-traumatic etiology is air migration of extrinsic origin, for example in pneumomediastinum or pneumothorax [10]. Exceptionally, trauma can lead to pneumorachis, this situation has been described at the cervical level following an extension of pneumocephalus secondary to craniofacial trauma with fracture of the skull base or paranasal sinuses or in spinal trauma [9–11].
Pneumorrhachis and hyponatremia after a neck hack—A case report
2020, International Journal of Surgery Case ReportsCitation Excerpt :The etiology of PR can be classified into iatrogenic, traumatic and nontraumatic. Several cases reports described conditions that may directly or indirectly produce PR such as barotraumas, physical exertions, respiratory complications, malignancy and its associated therapy [10–12]. In this traumatic case, the air entered the intraspinal space through the gaping neck wound and entrapped to a one-way air valve mechanism created by the paraspinal soft tissues.
Pneumorrhachis
2016, Complications in NeuroanesthesiaAcute tension pneumocephalus secondary to whole spine pneumorrhachis as an unusual presentation of a colon cancer complicated by a transsacral cerebrospinal fluid leak
2013, Journal of Clinical NeuroscienceCitation Excerpt :The term “pneumorrhachis” is used commonly to describe air penetration within the spinal canal, inside the epidural or subarachnoid space,1 and is reported mostly after major traumatic events, invasive procedures, thoracic or abdominal operations, and occasionally as a complication of intra-abdominal sepsis or chronic bowel disease.1–7
Pneumorrhachis: A rare complication of an asthma episode
2011, Medicina IntensivaTraumatic pneumorrhachis: Etiology, pathomechanism, diagnosis, and treatment
2011, Spine JournalCitation Excerpt :Iatrogenic PR can be a result of surgical interventions, anesthetic techniques, and diagnostic techniques [5,11,12]. Nontraumatic causes of intraspinal air include malignancy and its associated therapy [13], violent coughing because of bronchial asthma or acute bronchitis [14,15], single cases have been described in the literature after cardiopulmonary resuscitation, airway obstruction because of foreign body aspiration [16], two cases after physical exertion [17], inhalation drug abuse of 3,4-methylenedioxymethamphetamine (ecstasy) [18] or marijuana [19]. Furthermore, three cases have been reported after prolonged and forceful emesis because of diabetic ketoacidosis [20–22].