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Spontaneous pneumomediastinum COVID-19: Impact of mechanical ventilation
1 Resident in Radiology, Department of Radiology, National Institute of Oncology, UHC Ibn Sina, Rabat, Morocco
2 Specialist in Radiology at Department of Radiology, National Institute of Oncology, UHC Ibn Sina, Rabat, Morocco
3 Professor Chief of the Radiology, Department Oncology, National Institute UHC Ibn Sina, Rabat, Morocco
4 Professor, Department of Radiology, National Institute of Oncology, UHC Ibn Sina, Rabat, Morocco
Address correspondence to:
Suzanne Rita Aubin Igombe
MO, Radiology Resident, Department of Radiology, National Institute of Oncology, UHC Ibn Sina, Rabat,
Morocco
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Article ID: 100098Z06SI2021
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Koudouhonon RO, Igombe SRA, Wilson B, Jerguigue H, Latib R, Omor Y. Spontaneous pneumomediastinum COVID-19: Impact of mechanical ventilation. Case Rep Int 2021;10:100098Z06RK2021.ABSTRACT
No Abstract
Keywords: Computed tomography, COVID-19, Diagnosis, Pneumomediastinum
CASE REPORT
Coronavirus disease 2019 (COVID-19) has spread rapidly around the world and many studies have shown these typical and rare atypical findings, such as transient pneumothorax, spontaneous pneumomediastinum (SP), as well as emphysema subcutaneous during hospitalization.
This is the case in a 56-year-old woman with COVID-19, who presented during hospitalization, a spontaneous pneumomediastinum of low abundance. As her clinic worsened with dyspnea and impaired consciousness, she was put on mechanical ventilation in intensive care. Faced with the persistent symptomatology, a control thoracic computed tomography (CT) at 15 days of assisted ventilation found on the axial slice (Figure 1B) in parenchymal window, bilateral diffuse depoli glass areas with septal thickening, pneumomediastinum, and significant subcutaneous emphysema. Unfortunately our patient died a few days later.
DISCUSSION
Although the exact mechanism is unknown, the literature reports that an increase in alveolar pressure and the weakening of their walls related to the pronounced cough background in COVID-19 pneumonia make them more susceptible to rupture. Barotrauma has also been reported, linked to mechanical ventilation which in some cases could increase the pneumomediastinum and pre-existing emphysema [1],[2],[3],[4].
CONCLUSION
According to the literature and the analysis of cases, pneumothorax and pneumomediastinum have a high mortality of 60%. Thus, it is necessary to pay attention because their identification and early management can reduce this rate.
REFERENCE
1.
Mohan V, Tauseen RA. Spontaneous pneumomediastinum in COVID-19. BMJ Case Rep 2020;13(5):e236519. [CrossRef]
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Shan S, Guangming L, Wei L, Xuedong Y. Spontaneous pneumomediastinum, pneumothorax and subcutaneous emphysema in COVID-19: Case report and literature review. Rev Inst Med Trop Sao Paulo 2020;62:e76. [CrossRef]
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Goldman N, Ketheeswaran B. Wilson H. COVID-19-associated pneumomediastinum. Clin Med (Lond) 2020;20(4):e91–2. [CrossRef]
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Quincho-Lopez A, Quincho-Lopez DL, Hurtado-Medina FD. Case report: Pneumothorax and pneumomediastinum as uncommon complications of COVID-19 pneumonia-literature review. Am J Trop Med Hyg 2020;103(3):1170–6. [CrossRef]
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SUPPORTING INFORMATION
Author Contributions
Rita Oze Koudouhonon - Conception of the work, Design of the work, Acquisition of data, Analysis of data, Drafting the work, Revising the work critically for important intellectual content, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Suzanne Rita Aubin Igombe - Conception of the work, Design of the work, Acquisition of data, Analysis of data, Drafting the work, Revising the work critically for important intellectual content, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Biziman Wilson - Conception of the work, Design of the work, Acquisition of data, Analysis of data, Drafting the work, Revising the work critically for important intellectual content, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Hounayda Jerguigue - Conception of the work, Design of the work, Acquisition of data, Analysis of data, Drafting the work, Revising the work critically for important intellectual content, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Hounayda Jerguigue - Conception of the work, Design of the work, Acquisition of data, Analysis of data, Drafting the work, Revising the work critically for important intellectual content, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Rachida Latib - Conception of the work, Design of the work, Acquisition of data, Analysis of data, Revising the work critically for important intellectual content, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Youssef Omor - Conception of the work, Design of the work, Acquisition of data, Analysis of data, Drafting the work, Revising the work critically for important intellectual content, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Guarantor of SubmissionThe corresponding author is the guarantor of submission.
Source of SupportNone
Consent StatementWritten informed consent was obtained from the patient for publication of this article.
Data AvailabilityAll relevant data are within the paper and its Supporting Information files.
Conflict of InterestAuthors declare no conflict of interest.
Copyright© 2021 Rita Oze Koudouhonon et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.
