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A Case of Epidural Emphysema Caused by Vigorous Coughing

Korean Journal of Pediatrics 2004;47(9):1013-1015.
Published online September 15, 2004.
A Case of Epidural Emphysema Caused by Vigorous Coughing
Hye Rin Mok, Jin Hee Oh, Dae Kyun Koh
Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Korea
기침 후 발생한 척추 경막외 기종 1례
목혜린, 오진희, 고대균
가톨릭대학교 의과대학 소아과학교실
Correspondence: 
Jin Hee Oh, Email: jeany@catholic.ac.kr
Abstract
A 13-year-old boy was admitted via emergency room with dyspnea after vigorous coughing. Subcutaneous emphysema was palpated on both eyelids and around the neck. Breathing sound was slightly wheezy. On initial chest roentgenogram no parenchymal lesion or pneumothorax except subcutaneous emphysema on the thoracic wall was found. On the second day of hospitalization he showed agitation much more severe than the roentgenographic findings on the chest. Diffuse severe subcutaneous emphysema, pneumomediastinum, pneumopericardium, retroperitoneal pneumoperitoneum and epidural emphysema were found on computed tomography. He did not showed neurologic deterioration or respiratory difficulty demanding mechanical ventilation. He was treated with oxygen, bronchodilator and corticosteroids. After four days of hospitalization, tension pneumothorax finally developed which was successfully treated by closed thoracic tube drainage with water sealed bottle. The patient recovered without any sequelae after conservative care. On the follow up computed tomography no underlying pathologic lesion or residual emphysema was found.
Key Words: Epidural emphysema, Cough


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