title: Unique case of pneumomediastinum due to penetrating injury to the mediastinum.
abstract: Pneumomediastinum is a rare condition, and mostly occurs following traumatic or iatrogenic tracheal and oesophageal perforation, but spontaneous pneumomediastinum has also been described. We report a case of a 17-year-old woman who presented with a penetrating neck wound after a fall down the stairs. She had an extensive pneumomediastinum without signs of tracheal or oesophageal laceration, rib fractures, pneumothorax or haematothorax. The contaminated wound was surgically explored and extensively lavaged. Prophylactic antibiotic treatment was given and the patient recovered without complications. Direct perforating trauma to the mediastinum is a severe entity, but can be treated by lavage and prophylactic antibiotic therapy.
authors.affiliation: Department of Surgery, Slingeland Hospital Doetinchem, Doetinchem, The Netherlands.
authors.forename: Verena N N
authors.initials: VN
authors.lastname: Kornmann
authors.affiliation: Department of Surgery, Slingeland Hospital Doetinchem, Doetinchem, The Netherlands.
authors.forename: Leontien M
authors.initials: LM
authors.lastname: van Ravesteyn
authors.affiliation: Department of Anesthesia, Slingeland Hospital Doetinchem, Doetinchem, The Netherlands.
authors.forename: Hansjörg M
authors.initials: HM
authors.lastname: Reif
authors.affiliation: Department of Radiology, Slingeland Hospital Doetinchem, Doetinchem, The Netherlands.
authors.forename: Peter E J M
authors.initials: PE
authors.lastname: Sallevelt
authors.affiliation: Department of Surgery, Slingeland Hospital Doetinchem, Doetinchem, The Netherlands.
authors.forename: Ruby M
authors.initials: RM
authors.lastname: Krol
mesh_terms: D000058:Accidental Falls; D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008478:Mediastinal Emphysema / Q000188:drug therapy / Q000209:etiology*; D008482:Mediastinum / Q000293:injuries*; D014950:Wounds, Penetrating / Q000150:complications*
chemical_list: D000900:Anti-Bacterial Agents