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CASE REPORT  NON-COVID-19 SECTION Open accessopen access

Italian Journal of Emergency Medicine 2021 August;10(2):95-7

DOI: 10.23736/S2532-1285.21.00076-8

Copyright © 2021 THE AUTHORS

This is an open access article under the CC BY-NC-ND license

language: English

An unusual case of pneumorrhachis in a young man without symptoms: causes, diagnosis, and treatment

Domenico LOIZZI, Michele PIAZZOLLA , Nicoletta P. ARDÒ, Francesco SOLLITTO

Unit of Thoracic Surgery, AOU Ospedali Riuniti, Foggia, Italy

This paper aimed to illustrate the case of a pneumorrachis manifestation in a young man. A 18-year-old patient was referred to our Division from the Emergency Department for sudden onset of chest pain and subcutaneous emphysema of the neck. The CT scan showed air at the base of the neck, mediastinum, and the spinal cord channel. The neurological exam was regular. The neurosurgeons suggested 20 days of bed rest, and the pneumomediastinum resolved spontaneously without complication; so, the patient was discharged after of 48 hours of observation. It was observed that the Macklin effect could be linked to the onset of pneumomediastinum and pneumorrachis. Clinical observation for the onset of neurological symptoms is a cornerstone for the right and rapid treatment. Pneumorrachis is an unusual manifestation of violent cough, and it should always be considered for clinical observation, avoiding the insurgent of complications.

KEY WORDS: Epidural space; Pneumomediastinum, diagnostic; Case reports

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