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Case Report
Huge surgical emphysema and pneumomediastinum as a sequela to conservative dental restoration: A case report
1 MBBS – General Surgical Unaccredited Registrar, Department of General Surgery, Cairns Hospital, North Cairns, Queensland, Australia
2 MBBS – General Surgical Registrar, Department of General Surgery, Cairns Hospital, North Cairns, Queensland, Australia
3 FRACS – General Surgical Consultant, Department of General Surgery, Cairns Hospital, North Cairns, Queensland, Australia
Address correspondence to:
Arun Nadarajah
Department of General Surgery, Cairns Hospital, North Cairns, Queensland,
Australia
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Article ID: 100099Z12AN2022
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How to cite this article
Nadarajah A, Arron TY, Elston T. Huge surgical emphysema and pneumomediastinum as a sequela to conservative dental restoration: A case report. J Case Rep Images Surg 2022;8(1):1–4.ABSTRACT
Introduction: Subcutaneous emphysema and pneumomediastinum are rare sequelae of dental restorative procedure. Etiology includes tooth extraction, preparation of teeth, dental restoration, endodontic treatment, and subgingival curettage. All of which are related to the use of high-pressure manual and motorized tools.
Case Report: We present a rare case of elaborate pneumomediastinum with subcutaneous emphysema in a 75-year-old man who underwent a single molar “44” dental filling and presented to our regional hospital with the main complaint of facial swelling and odynophagia 1 hour post-procedure. The patient was managed conservatively through an uneventful hospital course, and fully recovered.
Conclusion: This case highlights the need for prompt diagnosis and management of subcutaneous emphysema and pneumomediastinum because of the risk of airway compromise, air embolism, and infection. Awareness of relatively “benign” pneumomediastinum as a result of a dental procedure is important especially in the rural and remote setting among general surgical teams. The mechanism, clinical presentation, differential diagnosis, and complications are also reviewed.
Keywords: Dental filling, Pneumomediastinum, Surgical emphysema
SUPPORTING INFORMATION
Author Contributions
Arun Nadarajah - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Tzu-Yi (Arron) Chuang - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Tim Elston - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Guarantor of SubmissionThe corresponding author is the guarantor of submission.
Source of SupportNone
Consent StatementWritten informed consent was obtained from the patient for publication of this article.
Data AvailabilityAll relevant data are within the paper and its Supporting Information files.
Conflict of InterestAuthors declare no conflict of interest.
Copyright© 2022 Arun Nadarajah et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.
