title: Subcutaneous emphysema associated with pneumomediastinum after general anesthesia--closed rhinolalia as an initial presentation in one of two cases.
abstract: We report two cases of subcutaneous emphysema associated with pneumomediastinum after general anesthesia. One of them was devoid of common symptoms such as chest pain and dyspnea, but significant closed rhinolalia was noted initially. Though in these two cases the chest CT scanning revealed no perivascular emphysema, we highly suspected that this phenomanum resulted from alveolar rupture with Macklin effect. Close observation was the best treatment since neither trachea injury was in evidence nor was there the occurrence of other complication. The differential diagnosis and approach to therapy are presented after review of the relevant literature.
authors.affiliation: Department of Anesthesiology, Taipei Veterans General Hospital, Taiwan, ROC.
authors.forename: Ya-Ying
authors.initials: YY
authors.lastname: Chang
authors.forename: Huey-Wen
authors.initials: HW
authors.lastname: Yien
authors.forename: Shu-Shya
authors.initials: SS
authors.lastname: Hseu
authors.forename: Kwok-Hon
authors.initials: KH
authors.lastname: Chan
authors.forename: Shen-Kou
authors.initials: SK
authors.lastname: Tsai
mesh_terms: D000328:Adult; D000768:Anesthesia, General / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008297:Male; D008478:Mediastinal Emphysema / Q000000981:diagnostic imaging / Q000209:etiology*; D013064:Speech Disorders / Q000209:etiology*; D013352:Subcutaneous Emphysema / Q000000981:diagnostic imaging / Q000209:etiology*; D014057:Tomography, X-Ray Computed