Pneumomediastinum following a prolonged second stage of labor - an emphasis on early diagnosis and conservative management: a case report

Esophageal rupture is an extremely rare condition to occur to a pregnant or postnatal woman. Esophageal ruptures have been previously described in the literature; however, they are most common in the setting of hyperemesis gravidarum. This case report describes a 27-year-old white woman who began co...

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Bibliographic Details
Published in:Journal of medical case reports 2017-11, Vol.11 (1), p.313-313, Article 313
Main Authors: Whelan, Stephanie, Kelly, Matthew
Format: Article
Language:English
Subjects:
Antibiotics
Apgar score
Care and treatment
Case Report
Case reports
Case studies
Childbirth & labor
Complications and side effects
Diagnosis
Electrocardiography
Emphysema
Esophageal rupture
Esophagus
Family medical history
Intrapartum
Labor (Obstetrics)
Medical diagnosis
Obstetrics
Pain
Pneumomediastinum
Pregnancy
Risk factors
Subcutaneous emphysema
Thyroid gland
Tomography
X-rays
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Summary:Esophageal rupture is an extremely rare condition to occur to a pregnant or postnatal woman. Esophageal ruptures have been previously described in the literature; however, they are most common in the setting of hyperemesis gravidarum. This case report describes a 27-year-old white woman who began complaining of central chest pain and shortness of breath 3 hours after a normal vaginal delivery, with no history of vomiting antenatally or intrapartum. A chest X-ray and computed tomography pulmonary angiogram confirmed surgical emphysema and pneumomediastinum, and a diagnosis of esophageal rupture was made based on these findings. She was stable and conservative management was initiated; she improved over 4 days. Resolution of surgical emphysema was demonstrated on serial chest X-rays without requiring contrast swallow or surgical intervention. This case exemplifies the importance of a timely diagnosis of esophageal rupture in ensuring a positive outcome for the patient. Delay in diagnosis can lead to an increase in morbidity and mortality.
ISSN:1752-1947
1752-1947
DOI:10.1186/s13256-017-1482-1