Pneumo-mediastinum secondary to Macklin effect: presentation of a case

Abstract

The thoracic traumatism is an emergent problem from the big cities when increasing the traffic accidents. The pneumomediastinum it has been reported until 10 % in patient with thoracic bruise, being due to Tracheobronchial lesions in less than 2 % of the cases. Although the cause of mediastinal emphysema is ignored in most of the patients, in many of them its etiologic could be by Macklin effect. This case tries on a 40 year-old masculine patient with the antecedent of complex trauma, presenting subcutaneous emphysema that affects the anterior part of the thorax until the ribs. In the radiological studies Neumomediastino is evidenced. Although the presence of the effect Macklin represents a challenge diagnosis, once this has settled down the handling it should be based on the treatment of the associate lesions. The presence of the Macklin effect show the degree of severity of the thoracic bruise, for these reason those patientes should be admited in ICU. The objective of this publication is to report a case of pneumomediastinum secundary to Macklin effect in a patient with closed trauma of thorax and take in considerations the fisiopatologic of this mechanism of air leak.