Abstract

*Hilendarov A., A. Georgiev, L. Chervenkov and N. Sirakov

ABSTRACT

Purpose of this presentation is to describe etiology and pathophysiology of pneumomediastinum, pneumothorax and subcutaneous emphysema, and illustrate the imaging features of massive pneumomediastinum, pneumothorax, subcutaneous emphysema and also a case of association with pneumoretroperitoneum and pneumoperitoneum. Materials and Methods: For a period of 5 years (2012-2017), 124 traumatic patients have undergone, examined and proved through an emergency department of the University Hospital. They were previously discussed at clinico-radiological meetings to determine adequate diagnostic and follow-up therapeutic behavior. In each of these studies, at least two imaging methods were performed to allow even minimal injuries. Chest X-rays, US examination, CT, and rarely MRI were used. Results and discussion: All of these patients have undergone, examined and proved through an Emergency and Diagnostic Imaging departments of the University Hospital. The obtained results were - in 37 patients pneumothorax, 64-pneumomediastinum, 23 subcutaneous emphysema. Spontaneous pneumothorax/SP/, occurs in 24 patients without underlying pulmonary disease. Iatrogenic pneumothorax occurs in 6 of our patients as complication of medical or surgical procedures. Traumatic pneumothorax was found in 5 of all 37 patients with pneumothorax and tension pneumothorax occurred in two patients. In 64 of all patients a pneumomediastinum was presented. Spontaneous pneumomediastinum occurs in 39 of all patients and tension pneumomediastinum are presented in 25 of all patients. In all emergency condition CT is the modality of choice. Conclusion:Therefore, it is possible to find amount of gas in mediastinum, pleural cavity and subcutaneous tissues in many different cases; as demonstrated, these conditions could be concurrent or isolated. Radiologist must know these conditions and, most of all, recognize the degree of severity and the onset of complications.