Tension pneumothorax and mediastinal emphysema occur more frequently than a review of the literature would lead one to believe. The fact that so few instances of these complications have been reported does not mean that they are rare, but rather indicates that they often go unrecognized. Even on postmortem examination the correct diagnosis may be missed unless the possibility of pneumothorax is borne in mind and the proper technic is used to demonstrate its presence.
In 1884 Champneys1 stated that in an examination of the post-mortem records of the Hospital for Sick Children (London) from 1860 to 1882 he had found reports of 82 cases of pneumothorax following tracheotomy. Mediastinal emphysema had been noted, in passing, in 5 cases (6 per cent), but pneumothorax was not mentioned. However, in the two years that elapsed after he published his first paper on mediastinal emphysema and pneumothorax, in 1882, there were 28
NEFFSON MA. TENSION PNEUMOTHORAX AND MEDIASTINAL EMPHYSEMA AFTER TRACHEOTOMY: GENERAL STUDY, WITH ANALYSIS OF SEVENTEEN CASES IN A SERIES OF ONE HUNDRED AND TWENTY-SIX TRACHEOTOMIES FOR ACUTE OBSTRUCTIVE INFECTIONS OF THE LARYNX, TRACHEA AND BRONCHI DURING THE PAST DECADE. Arch Otolaryngol. 1943;37(1):23–39. doi:10.1001/archotol.1943.00670030030003
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