gms | German Medical Science

Background: Emphysema of the neck may represent a dangerous conditions in some cases. If there is a history of a foreign body or trauma then investigations and treatment follow recognised standards. However emphysema without any etiological indices from the history represent a diagnostic and therapeutical challenge.

Patient collective: In the last few five years we have treated four patients (three male, one female) in the age of 3 -29 years with an cervical and/or mediastinal emphysema of unknown cause.

Results: Two young men with cervical emphysema without any possible cause in the history were observed and received a prophylactic antibiotic treatment. After involution of the emphysema we performed an endoscopy which revealed no abnormalities. A female patient and a 3-year-old boy had a history of cough attacks and a query history of a foreign body ingestion before the appearance of the emphysema. The immediate endoscopies were without pathologic findings. All patients recovered completely without any complications or recurrences.

Conclusions: Emphysema of the neck with unknown cause are rare. There are only few information about the incidence in literature. If there is no indication for a foreign body or a trauma in history or in radiological imaging, the endoscopy of the air way and the upper digestive tract should follow when the emphysema has subsided. The aim is to avoid any further spread of the emphysemsa and of germs. If there is a history of foreign body or trauma an immediate endoscopy is indicated.