PULMONARY BAROTRAUMA AS THE CAUSE OF PNEUMORETROPHARYNX IN PULMONARY LYMPHANGIOLEIOMYOMATOSIS

A 55-year-old white woman with pulmonary lymphangioleiomyomatosis (LAM ) presented to the emergency department with odynophagia and subplatys mal emphysema after a paroxysm of coughing. Lateral neck films showed subcutaneous emphysema and a retropharyngeal air stripe. Chest radiogr aphs showed neither pneumothorax nor pneumomediastinum. Patients with LAM frequently develop pulmonary barotrauma and pneumothoracies. This patient, however, had undergone prior bilateral talc pleuradesis as tr eatment for recurrent pneumothoracies and, thus, could not manifest th is complication of barotrauma. This case illustrates the uncommon occu rrence of superior dissection of air after pulmonary barotrauma. (Am J Emerg Med 1996;14:297-299. Copyright (C) 1996 by W.B. Saunders Compan y)