常见手术的罕见并发症:根管治疗后纵隔气肿。

Cemre Ozenbas, Sercan Aydin
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引用次数: 0

摘要

纵隔气肿是一种罕见但潜在的严重并发症,其特征是纵隔结构内存在空气。虽然它通常与胸部创伤或剧烈咳嗽有关,但也可能发生在涉及高速空气涡轮钻的牙科手术后。在这些过程中,空气可以进入颈筋膜平面,并可能延伸到纵隔,导致深颈部感染或纵隔炎等风险。本文报告了一位38岁的女性,在接受牙髓治疗的同一天出现了子宫颈肺气肿和纵隔气肿。计算机断层扫描(CT)成像显示空气密度从下颌区域延伸到纵隔。没有气胸、胸腔积液或心包积液的证据。患者给予保守氧疗和静脉注射抗生素治疗,一周内完全康复。本病例强调了在牙科手术后出现颈部肿胀和皮下crepitus的患者中识别纵隔气肿的重要性。由于可能被误诊为术后水肿、感染或过敏反应,早期CT成像对于准确诊断和及时干预至关重要。医疗保健专业人员对这种罕见并发症的认识在确保早期发现和有效的患者管理方面起着关键作用。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Rare complication of a common procedure: Pneumomediastinum following an endodontic procedure.

Pneumomediastinum is a rare but potentially serious complication characterized by the presence of air within mediastinal structures. Although it is typically associated with thoracic trauma or vigorous coughing, it can also occur following dental procedures involving high-speed air-turbine drills. During these procedures, air can enter the cervical fascial planes and potentially extend to the mediastinum, leading to risks like deep neck infections or mediastinitis. This report presents the case of a 38-year-old woman who developed cervical emphysema and pneumomediastinum on the same day following endodontic treatment. Computed tomography (CT) imaging demonstrated air densities extending from the submandibular region to the mediastinum. There was no evidence of pneumothorax, pleural effusion, or pericardial effusion. The patient was managed conservatively with oxygen therapy and intravenous antibiotics, resulting in complete recovery within one week. This case highlights the importance of recognizing pneumomediastinum in patients presenting with neck swelling and subcutaneous crepitus following dental procedures. Since it can be mistaken for postoperative edema, infection, or allergic reactions, early CT imaging is crucial for accurate diagnosis and timely intervention. Awareness of this rare complication among healthcare professionals plays a critical role in ensuring early detection and effective patient management.

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