Unrecognized pneumothorax as a cause of intraspinal air.
METHODS
This is a case report.


OBJECTIVE
A case of intraspinal air in a polytraumatized patient with unrecognized pneumothorax after blunt chest trauma is reported.


BACKGROUND
In most cases, intraspinal air is associated with degenerative disc disease, epidural abscess, or synovial cyst, or it follows iatrogenic manipulation. Scialdone and Wagle first reported a case of intraspinal air due to a laceration of the right main bronchus. No previous case of intraspinal air after a simple unsuspected pneumothorax following blunt chest trauma has been reported.


METHODS
During routine x-ray and computed tomography examination of a polytraumatized patient, an unsuspected pneumothorax due to a rib fracture was detected in a thorax computed tomography scan. Computed tomography scans of the cervical spine showed a collection of intraspinal air.


RESULTS
The computed tomography examination of a polytraumatized patient with an unsuspected pneumothorax after blunt chest trauma showed the embolization of air in the paravertebral vein plexus and in the intraspinal canal.


CONCLUSIONS
These observations suggest a wider indication for computed tomography scans of the thorax in blunt chest trauma. Also, whenever intraspinal air is found in the diagnostic course of a traumatized patient, a hidden pneumothorax should be suspected and ruled out.
Khodadadyan
C
C
Department of Trauma and Reconstructive Surgery, Free University of Berlin, Rudolf Virchow Medical Center, Germany.
Hoffmann
R
R
Neumann
K
K
Südkamp
N P
NP
D000328:Adult; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging*; D005740:Gases; D006801:Humans; D008297:Male; D009104:Multiple Trauma / Q000000981:diagnostic imaging; D011030:Pneumothorax / Q000150:complications* / Q000000981:diagnostic imaging / Q000209:etiology; D012253:Rib Fractures / Q000150:complications; D013115:Spinal Canal / Q000000981:diagnostic imaging*; D013898:Thoracic Injuries / Q000150:complications; D014057:Tomography, X-Ray Computed; D014949:Wounds, Nonpenetrating / Q000150:complications
D005740:Gases