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Mohamad R, Koubaissi SA, Bou Khalil P, Sfeir P. Tracheal Schwannoma Presenting as Subcutaneous Emphysema and Pneumomediastinum. BMJ Case Rep 2024; 17:e256951. [PMID: 38594197 PMCID: PMC11015168 DOI: 10.1136/bcr-2023-256951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/15/2024] [Indexed: 04/11/2024] Open
Abstract
Primary tracheal schwannomas are rare benign tumours. This is a case report, and therefore, no specific methods or results are applicable. We here report a case of a tracheal schwannoma in an early adolescent girl presenting with subcutaneous emphysema and symptoms of airway obstruction. Tracheal resection and reconstruction by primary anastomosis were performed. Pathology confirmed the diagnosis of tracheal schwannoma. This is an unusual life-threatening presentation of a benign rare tracheal tumour with a challenging approach to management.
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Affiliation(s)
- Rayan Mohamad
- Department of Internal Medicine, American University of Beirut, Beirut, Lebanon
| | - Salwa A Koubaissi
- Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Pierre Bou Khalil
- Department of Internal Medicine, American University of Beirut, Beirut, Lebanon
| | - Pierre Sfeir
- Department of Surgery, American University of Beirut, Beirut, Lebanon
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Vianello A, Caminati M, Chieco-Bianchi F, Marchi MR, Vio S, Arcaro G, Iovino S, Braccioni F, Molena B, Turato C, Peditto P, Battistella L, Gallan F, Senna G. Spontaneous pneumomediastinum complicating severe acute asthma exacerbation in adult patients. J Asthma 2017; 55:1028-1034. [PMID: 28991498 DOI: 10.1080/02770903.2017.1388392] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Objectives: The real incidence of pneumomediastinum (PNM) in adult patients with severe acute asthma exacerbation continues to be unknown. The current study aims to investigate the occurrence of PNM in an adult population of patients presenting a severe asthma attack and to evaluate the risk factors associated to its development. Methods: The 45 consecutive subjects who were admitted to our Division between January 1, 2015 and December 31, 2016 for severe acute asthma exacerbation underwent a diagnostic protocol including a standard chest X-ray and continuous monitoring of arterial oxygen saturation (SaO2) during the first 24 hours following admission. The patients showing persistence or deterioration of oxyhemoglobin desaturation were prescribed a chest Computed Tomographic (CT) scan. Results: Five out of the 45 patients (11.1%) with severe acute asthma exacerbation were diagnosed with PNM, in one case on the basis of an X-ray image and in four on the basis of a chest CT scan. Data analysis showed that the PNM patients were younger [21 (17-21) vs 49.5 (20-73) yrs; p < 0.001] and more likely to show sensitization to Alternaria (2/5 vs 0/40; p = 0.0101) with respect to their non-PNM counterparts. The duration of hospital stay was similar in the two groups [8 (4-12) vs 7 (3-15) days; p = 0.6939]. Conclusions: PNM is a common clinical entity in young adults with severe acute asthma exacerbation, particularly in those with unsatisfactory response to initial medical therapy. Although generally benign, patients with suspected PNM should be closely monitored because of the risk of developing severe hypoxemia.
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Affiliation(s)
- Andrea Vianello
- a Department of Cardio-Thoracic, Respiratory Pathophysiology Division , University-City Hospital of Padova , Padova , Italy
| | - Marco Caminati
- b Department of Medicine, Asthma Center , Verona University and General Hospital , Verona , Italy
| | - Fulvia Chieco-Bianchi
- a Department of Cardio-Thoracic, Respiratory Pathophysiology Division , University-City Hospital of Padova , Padova , Italy
| | - Maria Rita Marchi
- a Department of Cardio-Thoracic, Respiratory Pathophysiology Division , University-City Hospital of Padova , Padova , Italy
| | - Stefania Vio
- c Department of Radiology , University of Padova , Padova , Italy
| | - Giovanna Arcaro
- a Department of Cardio-Thoracic, Respiratory Pathophysiology Division , University-City Hospital of Padova , Padova , Italy
| | - Silvia Iovino
- a Department of Cardio-Thoracic, Respiratory Pathophysiology Division , University-City Hospital of Padova , Padova , Italy
| | - Fausto Braccioni
- a Department of Cardio-Thoracic, Respiratory Pathophysiology Division , University-City Hospital of Padova , Padova , Italy
| | - Beatrice Molena
- a Department of Cardio-Thoracic, Respiratory Pathophysiology Division , University-City Hospital of Padova , Padova , Italy
| | - Cristian Turato
- d Department of Surgery, Oncology and Gastroenterology , Veneto Institute of Oncology IOV - IRCCS , Padova , Italy
| | - Piera Peditto
- a Department of Cardio-Thoracic, Respiratory Pathophysiology Division , University-City Hospital of Padova , Padova , Italy
| | - Laura Battistella
- a Department of Cardio-Thoracic, Respiratory Pathophysiology Division , University-City Hospital of Padova , Padova , Italy
| | - Federico Gallan
- a Department of Cardio-Thoracic, Respiratory Pathophysiology Division , University-City Hospital of Padova , Padova , Italy
| | - Gianenrico Senna
- b Department of Medicine, Asthma Center , Verona University and General Hospital , Verona , Italy
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