Hemopneumothorax Associated with Pneumorrhachis Following Blunt Chest Trauma: A Case Report

Putu Eka Mardhika, Tjokorda GB Mahadewa and Citra Aryanti

Department of Neurosurgery, Udayana University, Indonesia
Department of Surgery, Udayana University, Indonesia

^*Correspondance to: Putu Eka Mardhika 

 PDF  Full Text DOI: 10.25107/2474-1647.2404

Abstract

Introduction: Pneumorrhachis is a condition that marked by presence of air in spinal canal. We present a rare case of pneumorrhachis of the cervical to thoracic canal associated with hemopneumothorax and flail chest with subcutaneous emphysema that recovered remarkably after shaft clipping surgery and chest tube insertion only. Pneumorrhachis can resolve by itself with conservative management. Case
Presentation: A 45-year-old woman suffered from chest pain and shortness of breath after fell at the hotel swimming pool. Further examination revealed rhonchi on left lung auscultation and asymmetry respiratory pattern. Computed tomography of the chest proved the presence of multiple rib fractures 4-9 left side, hemopneumothorax, subcutaneous emphysema. Accidentally, the CT showed intra spinal gas representing pneumorrhachis extending from C6-T3. No neurologic deficit was found. She was treated conservative by supplemental oxygen only, no further neurological deterioration was detected. Follow up examination was uneventful and the symptoms resolved completely.
Conclusion: Pneumorrhachis was mostly found accidentally with variety of underlying disease, especially in the case traumatic pneumothorax and fracture of skull base. Pneumorrhachis was managed conservatively and should be taken in attention in the presence of neurologic deficits.

Keywords

Ribs fracture; Pneumothorax; Pneumorrhachis

Cite the article

Mardhika PE, Mahadewa TGB, Aryanti C. Hemopneumothorax Associated with Pneumorrhachis Following Blunt Chest Trauma: A Case Report. Clin Surg. 2019; 4: 2404.