Tuberculosis and Respiratory Diseases

The Korean Academy of Tuberculosis and Respiratory Diseases (대한결핵및호흡기학회)
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The Treatment of Massive Spontaneous Subcutaneous Emphysema by Multiple Intravenous Catheter and Continuous Suction Drainage

다수의 정맥용 도관의 피하삽입과 지속흡인을 이용한 다량의 자발성 피하공기증 치료 1예

  • Kim, Sun Young (Department of Internal Medicine, Hallym University Colleage of Medicine) ;
  • Uom, Kwang Seok (Department of Internal Medicine, Hallym University Colleage of Medicine) ;
  • Lee, Young Seok (Department of Internal Medicine, Hallym University Colleage of Medicine) ;
  • Huh, Kyung Rim (Department of Internal Medicine, Hallym University Colleage of Medicine) ;
  • Kwon, Chin Woo (Department of Internal Medicine, Hallym University Colleage of Medicine) ;
  • Jang, Seung Hun (Department of Internal Medicine, Hallym University Colleage of Medicine) ;
  • Kim, Dong Gyu (Department of Internal Medicine, Hallym University Colleage of Medicine) ;
  • Jung, Ki Suck (Department of Internal Medicine, Hallym University Colleage of Medicine)
  • 김선영 (한림대학교 의과대학 내과학교실) ;
  • 엄광석 (한림대학교 의과대학 내과학교실) ;
  • 이영석 (한림대학교 의과대학 내과학교실) ;
  • 허경림 (한림대학교 의과대학 내과학교실) ;
  • 권진우 (한림대학교 의과대학 내과학교실) ;
  • 장승훈 (한림대학교 의과대학 내과학교실) ;
  • 김동규 (한림대학교 의과대학 내과학교실) ;
  • 정기석 (한림대학교 의과대학 내과학교실)
  • Received : 2006.05.11
  • Accepted : 2006.06.23
  • Published : 2006.08.30
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Abstract

A-61-year-old COPD patient was hospitalized due to dyspnea and was diagnosed with acute exacerbation of COPD. During the hospital stay, the patient's dyspnea was aggravated by massive spontaneous subcutaneous emphysema. Multiple 16 gauge intravenous catheters were inserted at the midclavicular line for drainage. Although subcutaneous catheter drainage was carried out, respiratory failure developed with an increased in massive subcutaneous emphysema. Continuous suction drainage with wall suction was applied resulting in the rapid resolution of the subcutaneous emphysema. We report a case of the that effective management of massive subcutaneous emphysema using multiple 16 gauge intravenous catheters with continuous suction.

61세 만성폐쇄폐질환 남자 환자로 호흡곤란을 주소로 내원하여 만성폐쇄성폐 질환 급성 악화 진단 하에 입원치료를 시작하였다. 입원치료 도중 다량의 자발성 피하공기증이 생기면서 호흡곤란이 악화되어 다수의 16 gauge 정맥용 도관 을 빗장중간선에 삽입하고 배출을 시도하였다. 그러나 피하공기증이 더욱 악화되어 wall suction으로 지속적인 흡인을 하였고 이후 피하공기증의 관해를 확인 할 수 있었다. 저자들은 16 gauge 정맥용 도관을 이용한 지속흡인으로 비침습 적이고 간편하게 피하공기증을 치료하였기에 문헌고찰과 함께 보고하는 바이다.

Keywords

References

  1. Hopkins RL., Hamre M, Davis SH, Bonis SL., Frieberg EM. Spontaneous subcutaneous emphysema. Am J Emerg Med 1994; 12:463-5 https://doi.org/10.1016/0735-6757(94)90064-7
  2. Herlan DB, Landreneau RJ, Ferson PF. Massive spontaneous subcutaneous emphysema: acute management with infraclavicular ''blow holes': Chest 1992; 102:503-5 https://doi.org/10.1378/chest.102.2.503
  3. Kelly MC, McGuigan JA, Allen RW. Relief of tension subcutaneous emphysema using a large bore subcutaneous drain. Anaesthesia 1995;50: 1077-9 https://doi.org/10.1111/j.1365-2044.1995.tb05955.x
  4. Sterif HM, Ott DA. The use of subcutaneous drains to manage subcutaneous emphysema. Tex Heart Inst J 1999;26;129-31
  5. Beck PL., Heitman SJ, Mody CH. Simple construction of a subcutaneous catheter for treatment of severe subcutaneous emphysema. Chest 2002; 121;647-9 https://doi.org/10.1378/chest.121.2.647
  6. Terada Y, Matsunobe S, Nemoto T, Tsuda T, Shimizu Y. Palliation of severe subcutaneous emphysema with use of a trocar-type chest tube as a subcutaneous drain. Chest 1993; 103;323
  7. Parker GS, Mosborg DA, Foley RW, Stiernberg CM. Spontaneous cervical and mediastinal emphysema. Laryngoscope 1990;100;938-40
  8. Jabourian Z, McKenna EL, Feldman M Spontaneous pneumomediastinum and subcutaneous emphysema. J Otolaryngol 1988; 17;50-3
  9. Steffey WR Cohn AM. Spontaneous subcutaneous emphysema of the head neck, and mediastinlflll. Arch Otolaryngol 1974; 100;32-5 https://doi.org/10.1001/archotol.1974.00780040036007
  10. Kirsh MM, Otvald TO. Mediastinal and subcutaneous emphysema complicating acute bronchial astlnna. Chest 1970;57;580-1 https://doi.org/10.1378/chest.57.6.580
  11. Maunder RJ, Pierson DJ, Hudson LD. Subcutaneous and mediastinal emphysema: pathophysiology, diagnosis, and management. Arch Intern Med 1984;144; 1447-53 https://doi.org/10.1001/archinte.144.7.1447
  12. Stack BC Jr, Ridley MB. Spontaneous cervical emphysema in a child. Otolaryngol Head Neck Surg 1994;110;318-23 https://doi.org/10.1016/S0194-5998(94)70776-6
  13. Leo F, Solli P, Veronesi G, Spaggiari L, Pastorino U. Efficacy of microdrainage in severe subcutaneous emphysema. Chest 2002;122;1498-9 https://doi.org/10.1378/chest.122.4.1498
  14. Conetta R, Barman AA, Iakovou C, Masakayan RJ. Acute vantilatory failure from massive subcutaneous emphysema. Chest 1993;104;978-80 https://doi.org/10.1378/chest.104.3.978
  15. Nair KK, Neville E, Rajesh P, Papaliya H. A simple method of palliation for gross subcutaneous surgical emphysema. J R Coll Surg Edinb 1989;34;163-4