Etiology, diagnosis and treatment strategy of dental therapy-related subcutaneous emphysema / 中华口腔医学杂志

Subcutaneous emphysema is the local tissue swelling caused by the gas entering the subcutaneous tissue through the tissue gap. Although subcutaneous emphysema is usually a nonfatal and self-limited disease, in severe cases, the gas may spread to the neck, mediastinum and chest, resulting in mediastinal emphysema and other serious complications. This article reviews the etiology, pathogenesis, clinical manifestations, diagnosis, differential diagnosis of subcutaneous emphysema related to dental therapy,and operations that may cause subcutaneous emphysema in stomatology department,as well as the treatment and prognosis of subcutaneous emphysema, with a view to providing some references for dentists.

Dolor cervical como presentación de neumomediastino espontáneo en urgencia pediátrica. Caso clínico / Cervical pain as presentation of spontaneous pneumomediastinum in pediatric emergency. Case report

Spontaneous Pneumomediastinum is a rare clinical situation in pediatric emergency services, sometimes it presents with guiding symptoms, but in other occasions in a very nonspecific way. Definitely, needs to be highly suspected, emphasizing in the anamnesis the antecedent of intense physical exercise before the development of the triggering symptoms that determinates the consult, generally having a good evolution that gets solved in 3-4 days. There is a pediatric clinical case presented, that permits us to discuss the more relevant aspects of the clinical presentation, diagnosis methods and the updated management, in pediatric emergency services.

Pneumomediastino espontâneo após esforço vocal: relato de caso / Spontaneous pneumomediastinum following vocal effort: a case report

Neste estudo é relatado o caso de um paciente do sexo masculino, 14 anos de idade, que após fazer grande esforço vocal, durante uma partida de futebol, desenvolveu quadro agudo de dor torácica. As radiografias de tórax e a tomografia computadorizada evidenciaram pneumomediastino, com pequeno pneumotórax bilateral. Os exames clínico, laboratoriais e radiológicos não demonstraram qualquer fator predisponente, ficando o caso classificado como pneumomediastino espontâneo.

The present article reports the case of a 14-year-old male patient who developed acute chest pain following increased vocal effort during a soccer game. Chest radiography and computed tomography demonstrated pneudomediastinum with small bilateral pneumothorax. Clinical, laboratory and radiological studies did not demonstrate any predisposing factor, and the case was classified as spontaneous pneudomediastinum.

Pneumomediastino en un paciente asmático: mecanismos de producción y diagnósticos diferenciales / Pneumomediatin in asthmatic patient: production mechanism and differentials diagnosis

El pneumomediastino o enfisema mediastinal consiste en la presencia de aire en el mediastino. Puede ocurrir complicaciones una variedad de patologías incluyendo el asma bronquial, Presentamos el caso de un paicente asmatico, quien durante una crisis severa desarrolla pneumomediastino. Se revisan los aspectos diagnósticos, implicaciones pronósticas y el tratamiento

Miliary tuberculosis with unusual matted giant mesenteric lymph nodes.

We report a case of miliary tuberculosis in a 10-month old female with unusual matted giant mesenteric lymph nodes. She presented with prolonged fever and poor feeding for two months. With the evidence of miliary pattern in chest X-ray and the positive acid-fast bacilli from the sputum, she was treated with antituberculous chemotherapy. She died from pneumomediastinum and pneumopericardium. Post-mortem findings disclosed miliary tuberculosis involving major organs. Acid-fast bacilli were numerous. Large matted mesenteric lymph nodes measuring 10 x 6 x 5 cm3 were noted. A strikingly large palpable matted mesenteric lymph nodes in suspected miliary tuberculosis should not be confused with tumors in the children.