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Surgical management of pneumomediastinum in the COVID-19 patient
  1. Michel Abou-Abdallah1,
  2. Samuel Dewhurst2,
  3. Henry Dunne3 and
  4. Ekpemi Irune3
  1. 1Ear, Nose and Throat Surgery, Addenbrooke's Hospital, Cambridge, UK
  2. 2Ear, Nose and Throat Surgery, North West Anglia NHS Foundation Trust, Peterborough, UK
  3. 3Ear, Nose and Throat Surgery, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
  1. Correspondence to Michel Abou-Abdallah; michel.abouabdallah{at}nhs.net

Abstract

As the SARS-CoV-2 virus continues to infect millions of people worldwide, the medical profession is seeing a wide range of short-term and long-term complications of COVID-19. One lesser-known complication is that of pneumomediastinum. This is a rare, but significant, complication defined by the presence of air in the mediastinum with an incidence of 1.2 per 100 000. Described mortality rate is 30%, increasing to 60% in patients with concomitant pneumothoraces. Management of pneumomediastinum is typically conservative, but in cases of extensive subcutaneous emphysema, cardiac or airway compression, life-saving surgical decompression is necessary. We report a case of pneumomediastinum secondary to COVID-19, requiring a surgical approach not described in pneumomediastinum secondary to COVID-19. The case demonstrates the importance of prompt diagnosis and management, as well as the potential for good clinical outcome in selected patients.

  • COVID-19
  • CPAP
  • Ear, nose and throat
  • Adult intensive care
  • Pneumomediastinum

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Footnotes

  • Contributors MA-A: conceptualisation of project, investigation—data collection, review of clinical notes, review of clinical images, resources—literature search and review, writing—original draft, visualisation. SD: conceptualisation of project. Methodology—primary surgeon for surgical intervention. Writing—review and editing, supervision. HD: investigation—data collection, review of clinical notes, review of clinical images, resources—literature search and review. Writing—review and editing: EI: conceptualisation of project, methodology—on-call consultant managing the case, writing—review and editing, supervision project administration.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.