S Koscielny1, R Gottschall. 1. HNO-Klinik der Friedrich-Schiller-Universität Jena, 07740 Jena. Sven.Koscielny@med.uni-jena.de
Abstract
BACKGROUND: Emphysema without any etiological indices from the history represents a diagnostic and therapeutic challenge. PATIENT COLLECTIVE: Over the last 5 years, we treated four patients (three male, one female; aged 3-29 years) with cervical and/or mediastinal emphysema of unknown cause. RESULTS: Two young men with cervical emphysema were observed and received prophylactic antibiotic treatment. After involution of the emphysema, we performed an endoscopy which revealed no abnormalities. A female patient and a 3-year-old boy had a history of coughing and a query history of foreign body ingestion before the appearance of the emphysema. The immediate endoscopies were without pathologic findings. All patients recovered completely without any complications or recurrences. CONCLUSIONS: If there is no indication for a foreign body or a trauma in the history or in radiological imaging, endoscopy of the airways and the upper digestive tract should follow when the emphysema has subsided. The aim is to avoid any further spread of the emphysema and of pathogens. If there is a history of a foreign body or trauma, an immediate endoscopy is indicated.
BACKGROUND:Emphysema without any etiological indices from the history represents a diagnostic and therapeutic challenge. PATIENT COLLECTIVE: Over the last 5 years, we treated four patients (three male, one female; aged 3-29 years) with cervical and/or mediastinal emphysema of unknown cause. RESULTS: Two young men with cervical emphysema were observed and received prophylactic antibiotic treatment. After involution of the emphysema, we performed an endoscopy which revealed no abnormalities. A female patient and a 3-year-old boy had a history of coughing and a query history of foreign body ingestion before the appearance of the emphysema. The immediate endoscopies were without pathologic findings. All patients recovered completely without any complications or recurrences. CONCLUSIONS: If there is no indication for a foreign body or a trauma in the history or in radiological imaging, endoscopy of the airways and the upper digestive tract should follow when the emphysema has subsided. The aim is to avoid any further spread of the emphysema and of pathogens. If there is a history of a foreign body or trauma, an immediate endoscopy is indicated.