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Basics of CT Scan Head and Trauma Radiographs
Published in Kajal Jain, Nidhi Bhatia, Acute Trauma Care in Developing Countries, 2023
Ujjwal Gorsi, Chirag Kamal Ahuja
Airway injuries are uncommon. Bronchial tears involve the right side, commonly within 2.5 cm of the carina. Radiographic findings include pneumothorax, pneumomediastinum and subcutaneous emphysema. Radiographic findings which suggest oesophageal injury are left pleural effusion, left lower lobe atelectasis, pneumomediastinum and left pneumothorax. Trauma to heart and pericardium may cause pericardial effusion or pneumopericardium. Radiographic features of effusion include global enlargement of the cardiac silhouette.
Less Lethal Weapons, Not Including Taser
Published in Darrell L. Ross, Gary M. Vilke, Guidelines for Investigating Officer-Involved Shootings, Arrest-Related Deaths, and Deaths in Custody, 2018
Christian Sloane, Gary M. Vilke
De Brito et al. (2001) examined 39 men and one woman between the ages of 16 and 77 who were shot by officers of either the Los Angeles Police Department or the Los Angeles Sheriff's Department. There was one fatality cause by massive hemothorax (bleeding into the lung cavity) after thoracic penetration of the beanbag. The locations of serious penetrating injuries included the thoracic cavity, eye, abdomen, arm, and leg. Blunt injuries included splenic rupture, pneumothorax, compartment syndrome, testicular fracture, subcapsular liver hematoma, and cardiac contusion. Complications included hemothorax, pneumopericardium (air around the heart), wound infection, compartment syndrome, and osteomyelitis. The majority of the subjects involved had psychiatric diagnoses. All but one had toxicology screenings performed, of which 29 (74.4 percent) were positive. Of those 29 positive results, 15 (51.7 percent) were positive for alcohol and eight (27.6 percent) were positive for cocaine.
Pulmonary air leaks
Published in Prem Puri, Newborn Surgery, 2017
Pneumopericardium is the least frequent pulmonary air leak. However, recently, it has been occurring with increasing frequency as a complication of ventilatory therapy. Pneumopericardium can develop while the patients are on high-frequency ventilation respiratory support.50 Neonatal pneumopericardium has also been reported during nasal continuous positive airway pressure (CPAP) ventilation and in a full-term neonate following a forceps delivery and mild asphyxia. The exact etiology of pneumopericardium is not known; it is probably interstitial pulmonary air, secondary to alveolar rupture, which dissects into the mediastinum and then enters the pericardial space at the reflection of the pericardium onto the great vessels.
A teenaged patient with spontaneous pneumopericardium after hookah smoking
Published in Clinical Toxicology, 2022
An initial evaluation to determine the etiology for a teenaged patient with undifferentiated CP included: normal EKG [normal sinus rhythm, with no evidence of arrhythmia, ventricular hypertrophy, or ischemia]; chest radiographic imaging (Figures 1 and 2) revealed a spontaneous pneumopericardium [SPP] [arrows]. Serum troponin was <0.010. A serum carboxyhemoglobin level was not measured. The patient was admitted to the intensive care unit, and treated with supplemental oxygen to effect a “nitrogen washout”. There was complete radiographic resolution of the SPP after 24 h of oxygen therapy. It was only after multiple interviews by the medical team that he admitted to hookah smoking of cannabis for the past year, several times per week; and that he had smoked a hookah approximately 2 h prior to CP onset.
Spontaneous pneumomediastinum complicating severe acute asthma exacerbation in adult patients
Published in Journal of Asthma, 2018
Andrea Vianello, Marco Caminati, Fulvia Chieco-Bianchi, Maria Rita Marchi, Stefania Vio, Giovanna Arcaro, Silvia Iovino, Fausto Braccioni, Beatrice Molena, Cristian Turato, Piera Peditto, Laura Battistella, Federico Gallan, Gianenrico Senna
All the patients presenting in the ED because of severe acute asthma exacerbation underwent the following diagnostic protocol: A standard chestFigure 1 X-ray was carried out by the Radiology Service of the ED before the patient was admitted to the ward. An upright postero-anterior chest radiograph was performed whenever possible depending on the patient's performance status and level of collaboration. In other cases (i.e., patients with severe mobility limitations), an antero-posterior supine radiograph was performed. Lateral chest radiographs were prescribed only for the subjects who were fully able to cooperate and to maintain an upright posture without assistance. Chest X-ray images were subsequently read by a board-certified radiologist. A diagnosis of PNM was made depending on the presence of at least one of the following radiographic signs: subcutaneous emphysema; air anterior to the pericardium (pneumopericardium); air around the pulmonary artery and the main branches (“ring around artery” sign); air outlining the major aortic branches (“tubular artery” sign); air outlining the bronchial wall (“double bronchial wall” sign); the “continuous diaphragm” sign, due to air trapped posterior to pericardium; air between the parietal pleura and diaphragm (“extrapleural” sign) [19].Continuous pulse oximetry SaO2 monitoring (Nonin Model 9500, Plymouth, Minnesota) during the first 24 hours following admission. Recovery from exacerbation was defined as a return to a SaO2 baseline above 95% for a patient spontaneously breathing room air.
Late onset pneumopericardium after lung transplantation
Published in Acta Cardiologica, 2021
Pneumopericardium is an exceptional complication of lung transplantation. The opening of the pericardial sac during intervention, necessary for the anastomosis of the pulmonary venous drainage, establishes a connection between the pleural and pericardial cavities, which is mostly maintained after the transplant. Other, often pathogenic, mechanisms can also be involved, including infections of the pericardium, barotrauma as a consequence of mechanical ventilation, formation of fistulas to the pericardial sac, bronchial dehiscence at the anastomosis and complications of invasive procedures.