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Figure 1. A 76-year-old man with chronic obstructive pulmonary disease was admitted after a car accident. The initial clinical and radiographic evaluation showed no evidence of rib fractures or other chest trauma. Several hours later, his neck and upper chest became increasingly swollen. Crepitations were detected on palpation of the swollen areas. Respiratory failure developed (respiratory rate, 36 per minute; pulse rate, 120 per minute; and blood pressure, 120/75 mm Hg). A chest x-ray film showed pneumomediastinum (open arrows) and extensive subcutaneous emphysema (solid arrow) that appeared in part as a cast of the muscles of the upper chest . . . [Full Text of this Article] |
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