Presentation
Voice changes and facial edema following percutaneous lung biopsy (initially complicated by small resolving pneumothorax).
Patient Data
Extensive pneumomediastinum and soft tissue emphysema extending from the anterior chest wall to the soft tissues of the neck, the posterolateral chest wall and both arms. There is retropharyngeal air in the neck which exerts mass effect on the posterior pharyngeal wall. The trachea is narrowed and there is flattening of the anterior wall of the right atrium and right ventricle secondary to extrinsic pressure from the pneumomediastinum.
Case Discussion
Tension pneumomediastinum is a potentially fatal condition which can obstruct venous return to the heart and cause airway obstruction.
Chest wall emphysema reduces compliance and restricts ventilation.
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