fek macklin pada kasus trauma- pneumomediastinum dan emfisema interstitial

Ni Putu Popy Theresia Puspita; D G Mahiswara

doi:10.15562/medicina.v51i3.674

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fek macklin pada kasus trauma- pneumomediastinum dan emfisema interstitial

Ni Putu Popy Theresia Puspita ,

D G Mahiswara ,

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DOI: https://doi.org/10.15562/medicina.v51i3.674 |
Published: 2020-09-30

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Abstract

The Macklin effect is developed by alveolar ruptures, air dissection along bronchovascular sheaths, and spreading of this pulmonary interstitial emphysema into the mediastinum. Radiology examination has an important rule to reveal a Macklin effect cases. We present a 62-years-old male with alleged history of falling from a tree as high as 10 meters presented with chest pain and breathlessness for 6 hours before admission in the emergency department (ER) of Sanglah Hospital. Examination of his chest showed a subcutaneous emphysema with normal breath sound. The supine chest radiograph obtained at admission was considered a pneumomediastinum, large subcutaneous emphysema of the coli region to bilateral hemithorax and right pulmonary contusion. Urgent CT scan thorax revealed pneumomediastinum, bilateral pleural effusion, contusion pulmonum right paracardial, fracture of the 9th and 10th spinous procesus thoracal vertebral corpus, subcutaneous emphysema hemithorax region to bilateral coli.Â

Efek Macklin terjadi akibat ruptur alveolar, diseksi udara sepanjang selubung bronkovaskular, dan emfisema interstitial paru hingga mediastinum. Pemeriksaan radiologi memiliki peran penting dalam menegakkan kasus efek Macklin. Kami membawakan sebuah kasus, seorang laki-laki berusia 62 tahun dengan riwayat jatuh dari pohon setinggi 10 meter dengan keluhan nyeri dada dan sesak napas selama 6 jam sebelum masuk di unit gawat darurat (UGD) Rumah Sakit Sanglah. Pada pemeriksaan fisik dada menunjukkanÂ emfisema subkutan dengan suara napas normal. Radiografi toraks menunjukkan pneumomediastinum, emfisema subkutis luas pada daerah coli hingga hemitoraks bilateral dan kontusio paru kanan. CT scan menunjukkan adanya pneumomediastinum, efusi pleura bilateral, kontusio paru paracardial kanan, fraktur procesus spinosus korpus torakalis 9 dan 10, emfisema subkutan regio hemitoraks hingga coli bilateral.

Keywords: interstitial emphysema Macklin effect pneumomediastinum radiographics trauma

References

Mehmet Unlu, Pinar Cimen, EmreOner. An Unusual Cause of Cough: Hammanâ€™s Syndrome. International Journal of Scientiï¬c Study Vol 3, Issue 6. September 2015
G.C. Colin, F.C. Deprez, P. Bosschaert. MDCT Features of Spontaneous Pneumomediastinum By Macklin Effect. JBRâ€“BTR, 2012, 95: 98-100.
Iyer V.N., Joshi A.Y., Ryu J.H.: Spontaneous pneumomediastinum: analysis of 62 consecutive adult patients. Mayo Clin Proc, 2009, 84: 417-421.
Sadayuki Murayama, Shinji Gibo. Spontaneous pneumomediastinum and Macklin effect: Overview and appearance on computed tomography. World J Radiol 2014 November 28; 6(11): 850-854

How to Cite

Popy Theresia Puspita, N. P., & Mahiswara, D. G. (2020). fek macklin pada kasus trauma- pneumomediastinum dan emfisema interstitial. Medicina, 51(3). https://doi.org/10.15562/medicina.v51i3.674