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CASE REPORT
Year : 2013  |  Volume : 4  |  Issue : 1  |  Page : 2

Spontaneous pneumomediastinum in diabetic ketoacidosis; a case report


1 Department of Anesthesia and Intensive Care, Neurointensive Care Unit. Ospedale San Filippo Neri Roma Via Martinotti 20 00100, Rome - Italy
2 Department of General Emergency, Neurointensive Care Unit. Ospedale San Filippo Neri Roma Via Martinotti 20 00100, Rome - Italy

Correspondence Address:
A Cerroni
Department of Anesthesia and Intensive Care, Neurointensive Care Unit. Ospedale San Filippo Neri Roma Via Martinotti 20 00100, Rome - Italy

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Source of Support: None, Conflict of Interest: None


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A 22 year old male, with a history of cannabis and periodical alcohol abuse, patient of type 1 diabetes since the age of 19 years, presented to the emergency department after one day of lethargy and vomiting. At physical examination a dehydrated male with tachycardia, hypotension and Kussmaul's respiration was found. No other physical abnormalities were found, except for palpable skin, crepitations in the supraclavicular fossae that prompted immediate radiological investigations with chest X-ray and successive thorax computed tomography scan. Laboratory investigation was significant for metabolic acidosis. Pneumomediastinum is an uncommon complication of diabetic ketoacidosis that should be kept in mind to avoid unnecessary radiological investigations, dietary restriction and antibiotic administration with prolonged hospitalization and eventually delayed treatment of the underlying condition.


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