Pneumomediastinum and surgical emphysema after endotracheal intubation

Case contributed by Muhammad Shoyab


Covid-19 patient. Oxygen saturation 96% on ventilator.

Patient Data

Age: 40 years
Gender: Male

Endotracheal tube in situ.

Lungs: Tiny nodular opacities and round lucencies all in both lung fields. Wedge shaped area of airspace opacification involving the peripheral region of the middle and the lower zone of the right lung field.

Mediastinum: Air lucency along right principal bronchus as well as upper and lower lobar bronchi.

Chest wall: Air lucency in both axillae, as well as the lower neck on both sides, producing ginkgo leaf sign.

Case Discussion

Pneumomediastinum as evidenced by air lining the trachea and right-sided bronchi.

Surgical emphysema and pneumomediastinum in the setting of recent endotracheal intubation are likely due to tracheal injury during intubation.

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