Clinical presentation
the neck becomes distended with air (204) .
Diagnosis
physical examination and aspiration of air and radiography of neck will indicate the diagnosis. endoscopy of the air sac may help to localize the site of rupture, and biopsy of the air sac may better determine the aetiological agent. this condition must be differentiated from aerophagia.
Management
the underlying cause should be identified and treated. lancing the distension with a scalpel or the bevelled edge of a needle, tearing through both skin and air sac, will deflate the air sac. this may have to be done several times until the originating rupture has healed. refractory cases may require the placement of an acrylic stent in the most prominent area of the distension. purpose-made stents are available and are implanted surgically under general anaesthesia. an alternative technique has been developed that creates a shunt between the cervicocephalic air sac and the clavicular air sac, avoiding the maintenance of an external stent.
發表於 2011-9-20 00:52
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~麻煩啦
