Subcutaneous emphysema, pneumomediastinum, pneumothorax, pneumoperitoneum, and pneumoretroperitoneum by insufflation of compressed air at the external genitalia in a child.
A 7-year-old girl with concurrent subcutaneous emphysema, pneumomediastinum, pneumothorax, pneumoperitoneum, and pneumoretroperitoneum arrived at our facility. Compressed air at 5 atm of pressure was insufflated through the nozzle of a spray gun over her external genitalia. She was admitted for a small amount of genital bleeding and significant subcutaneous emphysema extending from the cheek to the upper body. Radiographic examination of the abdomen was suggestive of a visceral perforation, but she was managed conservatively and discharged in satisfactory condition without surgical intervention. The female genitalia possibly served as the entry point for air into the retroperitoneum and peritoneal cavity, with subsequent migration of air through the esophageal hiatus that resulted in pneumomediastinum, pneumothorax, and extensive subcutaneous emphysema.
Department of Pediatric Surgery, Oita Prefectural Hospital, Oita City 870-0767, Japan. c-kmuramori@eph.pref.ehime.jp
Katsumi
K
Muramori
Yukiko
Y
Takahashi
Noritoshi
N
Handa
Hisayuki
H
Aikawa
D002648:Child; D005260:Female; D005500:Follow-Up Studies; D005836:Genitalia, Female / Q000293:injuries*; D006801:Humans; D008478:Mediastinal Emphysema / Q000150:complications / Q000000981:diagnostic imaging* / Q000628:therapy; D009104:Multiple Trauma / Q000000981:diagnostic imaging / Q000628:therapy; D011027:Pneumoperitoneum / Q000150:complications / Q000000981:diagnostic imaging* / Q000628:therapy; D011030:Pneumothorax / Q000150:complications / Q000000981:diagnostic imaging* / Q000628:therapy; D013902:Radiography, Thoracic; D018570:Risk Assessment; D012720:Severity of Illness Index; D013352:Subcutaneous Emphysema / Q000150:complications / Q000000981:diagnostic imaging* / Q000628:therapy; D014057:Tomography, X-Ray Computed