The Diagnosis and Management of Patient with Delayed Symptoms from a Tracheal Tear.

N. B. Greilich, I. Gasanova, B. Farrell, G. Joshi
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Abstract

Development of subcutaneous emphysema after gastrointestinal endoscopy with general anesthesia presents a diagnostic conundrum. We discuss the management of a patient who experienced significant vomiting followed by neck and facial swelling with crepitus and shortness of breath after the endoscopic retrograde cholangiopancreatography. The presence of respiratory distress usually suggests that head and neck subcutaneous emphysema is most likely associated with pneumothorax and/or pneumomediastinum. We discuss the prevention, differential diagnosis, and current management of tracheal tears including subcutaneous emphysema.
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气管撕裂后迟发症状的诊断与处理
胃肠内窥镜全麻后皮下肺气肿的发展提出了一个诊断难题。我们讨论了一个病人经历了明显的呕吐,随后颈部和面部肿胀,在内窥镜逆行胰胆管造影术后,毛骨悚然和呼吸短促。呼吸窘迫的出现通常提示头颈部皮下肺气肿最可能伴有气胸和/或纵隔气肿。我们讨论预防,鉴别诊断,和目前管理的气管撕裂包括皮下肺气肿。
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