UNRECOGNIZED PNEUMOTHORAX AS A CAUSE OF INTRASPINAL AIR

Study Design. This is a case report. Objective. A case of intraspinal air in a polytraumatized patient with unrecognized pneumothorax after blunt chest trauma is reported. Summary of Background Datal. In most c ases, intraspinal air is associated with degenerative disc disease, ep idural abscess, or synovial cyst, or it follows iatrogenic manipulatio n. Scialdone and Wagle first reported a case of intraspinal air due to a laceration of the right main bronchus. No previous case of intraspi nal air after a simple unsuspected pneumothorax fol- towing blunt ches t trauma has been reported. Methods. During routine x-ray and computed tomography examination of a polytraumatized patient, an unsuspected p neumothorax due to a rib fracture was detected in a thorax computed to mography scan. Computed tomography scans of the cervical spine showed a collection of intraspinal air. Results. The computed tomography exam ination of a polytraumtized patient with an unsuspected pneumothorax a fter blunt chest trauma showed the embolization of air in the paravert ebral vein plexus and in the intraspinal canal. Conclusion. These obse rvations suggest a wider indication for computed tomography scans of t he thorax in blunt chest trauma. Also, whenever intraspinal air is fou nd in the diagnostic course of a traumatized patient, a hidden pneumot horax should be suspected and ruled out.