A Case of Spontaneous Mediastinal Emphysema with Spontaneous Pneumothorax

Abstract

A 72 year-old man was undergoing hemodialysis therapy for chronic renal failure. A chest X-ray film showed collapse of the right lung, which caused chest distress and shortness of breath. Therefore chest drainage was performed immediately. Although the right lung expanded properly and showed no air leakage, obvious subcutaneous emphysema appeared just three days after the therapy. No air leakage was found via the drainage tube. Considering the possibility of a clog of the tube, the tube was replaced. However, there was still no air leakage from the tube. Since no air leakage was found in or around the drainage tube, this was diagnosed as the spontaneous mediastinal emphysema, which occurred following spontaneous pneumothorax. In cases of weakened lungs, including pulmonary emphysema or dialysis, it is necessary to treat the patient considering the potential need to treat idiopathic mediastinal emphysema.