Luviano GJA, Sánchez HCRG

Language: Spanish
References: 15
Page: 94-98
PDF size: 223.42 Kb.

ABSTRACT

Introduction: This is an infrequent disease. The diagnosis is made with high suspicion and chest radiography. The treatment is conservative.
Objective: Present the diagnostic approach, clinical and treatment polytraumatized patient with pneumomediastinum and pneumoperitoneum.
Design: A case report.
Site: UCI Medical Unit of High Specialty number 21 of Monterrey, Nuevo Leon.
Patient: A 19 years old man, previously healthy, suffers a car accident, Initial Glasgow 6, diagnosis of Severe Head Injury, interventricular hemorrhage that warrants ventricular drainage and panfacial fracture. At Intensive Care admissions the patient develop patient-ventilator asynchrony. Warrants change of orotracheal tube to 7 a 8.5 fr, were many attempts because difficult airway; previous to insertion of bulboyugular saturation catheter, medical staff finding a cervical subcutaneous emphysema; monitoring with chest radiography showed suggestive evidence of pneumomediastinium, corroborating in computed tomography and pneumoperitoneum. Laryngeal and tracheal injury was discarded with laryngoscopy and bronchoscopy; laparotomy discarded hollow viscera injury. The treatment was conservative; the patient does not warrant chest drain. The tracheostomy and gastrostomy was performed for neurological status. The patients discharged with Glasgow of 10 points.

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