Mustafa UZKESER, Hüseyin ŞAHİN, Sultan Tuna Akgöl GÜR, Şahin ASLAN

Travmatik Pnömomediastinum: Olgu Sunumu

Travmatik pnömomediastinum (TPM) nadir görülen bir tablodur. TPM baş, boyun, göğüs ve nadiren de ağız yaralanmaları sonucunda oluşabilir. Kırk üç yaşında erkek hasta motorlu taşıt kazasından yaklaşık 3 saat sonra göğüs ağrısı ve nefes darlığı ile Acil servise getirildi. Yapılan muayenede yüzde, boyunda ve göğüste yaygın bilateral cilt altı amfizemi ve krepitasyonu mevcuttu. Elektrokardiyografisinde birinci derece AV blok görüldü. Yatarak çekilen yatarak göğüs grafisi, yan boyun grafisi ve toraks tomografisinde ciltaltı ve mediastende hava görüldü. Hasta hospitalize edildikten sonra yapılan endoskopisi ve bronkoskopisi normal olarak değerlendirildi. Hospitalizasyonunun 2. gününde mediatinal amfizemin basınç etkisinde dolayı mediastinotomi yapıldı. İlerleyen günlerde ortaya çıkan pnömothoraks ve mediastinal amfizem tamamen iyileşti. Hasta 6. gününde sekelsiz olarak taburcu edildi. Eğer trakea ve özefagus yaralanması önceden mevcut ise TPM önemli bir durumdur.

Anahtar Kelimeler:

Travma, mediasten, mediastende hava, cilt altı amfizem

Traumatic Pneumomediastinum: Case Report

Traumatic pneumomediastinum (TPM) is a rare entity. TPM may occur as a result of head, neck and thorax injury and rarely after oral injury. A 43-year-old man was brought to our ED approximately three hours after a motor vehicle accident (MVA) with complaints of angina pectoris and dyspnoea. His positive clinical findings were extensive bilateral subcutaneous emphysema and crepitation on his face, neck and trunk bilaterally. Electrocardiogram showed a first degree AV block. Supine chest x-ray, lateral neck x-ray and thorax CT showed subcutaneous and mediastinal air. After hospitalisation, bronchoscopy and endoscopy were performed with normal findings. On the second day, mediastinotomy was performed due to a pressure effect of the mediastinal emphysema. Complete resolution of the pneumothorax and mediastinal emphysema occurred gradually in the following days. He was discharged without any complication on the 6th day. TPM is an important issue if pre-existing trachea or oesophagus injury is present

Keywords:

Trauma, mediastinum, mediastinal air, subcutaneous emphysema,

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