自發性頸部皮下氣腫併縱膈腔氣腫

Spontaneous Cervical Subcutaneous Emphysema And Pneumomediastinum

頭頸部皮下氣腫合併縱膈腔氣腫可以區分為自發性以及非自發性兩類。在無明顯外力或醫源性傷害所產生的組織間質氣腫定義為自發性氣腫。這是一種少見且好發於年輕成人的疾病，患者本身可能潛在某些呼吸道疾病（例如：氣喘、慢性阻塞性肺病、呼吸道感染、或吸菸），然後經由近期的誘發因子（例如：劇烈嘔吐咳嗽、激烈運動）而發病。
我們報告一位二十歲女性因喝豆漿嗆食導致發生下頸以及前胸疼痛。影像檢查顯示皮下氣腫從頸部延伸到後咽間隙及縱膈腔。病患接受保守治療三天後完全康復。皮下氣腫是預後良好的疾病且甚少造成致命的後果，如同我們所呈現的個案，大多數只要接受保守治療就能完全康復。

Subcutaneous emphysema of the head and neck with pneumomediastinum is classified into two categories: spontaneous and nonspontaneous. Spontaneous subcutaneous emphysema with pneumomediastinum has been defined as the presence of interstitial air in the subcutaneous tissue or the mediastinum without any apparent trauma or iatrogenic injury. The disease is rare, typically affects young adults, often results from predisposing factors (e.g., asthma, chronic obstructive pulmonary disease (COPD), airway infection, or smoking), and is induced by recent precipitating factors (e.g., fierce vomiting, coughing , or intense physical exertion).
We describe a 20-year-old woman who experienced pain in her lower neck and anterior chest after she choked when drinking soy milk. Radiological studies revealed a subcutaneous emphysema in the neck, extending from the retropharyngeal space to the mediastinum. The patient recovered after 3 days of conservative therapy.
Subcutaneous emphysema is a benign entity that seldom results in catastrophic events, and therefore requires only conservative management, as in the present case.