Laryngeal Injury and Pneumomediastinum Due to Minor Blunt Neck Trauma: Case Report.
BACKGROUND
Serious isolated laryngeal injuries are uncommon in children.


METHODS
We describe the case of an 8-year-old boy with laryngeal injury and pneumomediastinum due to minor blunt neck trauma. He presented to the emergency department complaining of odynophagia and hoarseness, but without respiratory distress. Emphysema was seen between the trachea and vertebral body on initial cervical spine x-ray study, and flexible laryngoscopy revealed erythema and mild edema of both the right vocal cord and the arytenoid region. He recovered with conservative management only. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: We conclude that it is important to recognize subtle evidence of laryngeal injury secondary to blunt neck trauma to ensure early diagnosis. Initial cervical spine x-ray assessment should exclude both cervical spine fracture and local emphysema after blunt neck trauma. If patients with blunt neck trauma have evidence of a pneumomediastinum, the clinician should consider the possibility of aerodigestive injury.
Department of Pediatrics, Tsugaruhoken Medical CO-OP Kensei Hospital, Hirosaki, Aomori, Japan.
Yasutaka
Y
Kuniyoshi
Department of Pediatrics, Tsugaruhoken Medical CO-OP Kensei Hospital, Hirosaki, Aomori, Japan.
Azusa
A
Kamura
Department of Pediatrics, Tsugaruhoken Medical CO-OP Kensei Hospital, Hirosaki, Aomori, Japan.
Sumie
S
Yasuda
Department of Pediatrics, Tsugaruhoken Medical CO-OP Kensei Hospital, Hirosaki, Aomori, Japan.
Makoto
M
Tashiro
Department of Intensive Care, Tsugaruhoken Medical CO-OP Kensei Hospital, Hirosaki, Aomori, Japan.
Yoichiro
Y
Toriyabe
D002648:Child; D004636:Emergency Service, Hospital / Q000458:organization & administration; D006685:Hoarseness / Q000209:etiology; D006801:Humans; D007828:Laryngoscopy / Q000379:methods; D007830:Larynx / Q000293:injuries*; D008297:Male; D008478:Mediastinal Emphysema / Q000150:complications / Q000209:etiology*; D019838:Neck Injuries / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology; D013352:Subcutaneous Emphysema / Q000209:etiology; D014057:Tomography, X-Ray Computed / Q000379:methods; D014827:Vocal Cords / Q000293:injuries; D014949:Wounds, Nonpenetrating / Q000150:complications*
blunt neck trauma; laryngeal injury; pneumomediastinum