Hemopneumothorax associated with pneumorrachis following blunt chest trauma

Abstract

Pneumorrhacis is a condition marked by the presence of air in the spinal canal. We present a rare case of pneumorrachis of the cervical to thoracic canal associated with hemopneumothorax and flail chest with subcutaneous emphysema that recovered remarkably after shaft clipping surgery and chest tube insertion only. Pneumorrachis can resolve by itself with conservative management. A 45-year-old woman suffered from chest pain and shortness of breath after fell at the hotel swimming pool. Further examination revealed rhonchi on left lung auscultation and asymmetry respiratory pattern. Computed tomography of the chest proved the presence of multiple rib fractures 4-9 left side, hemopneumothorax, subcutaneous emphysema. Accidentally, the CT showed intraspinal gas representing pneumorrachis extending from C6-T3. No neurologic deficit was found. She was treated conservative by supplemental oxygen only, no further neurological deterioration was detected. Follow up examination was uneventful and the symptoms resolved completely. Pneumorrachis was mostly found accidentally with a variety of underlying diseases, especially in the case of traumatic pneumothorax and fracture of the skull base. Pneumorrachis was managed conservatively and should be taken in attention in the presence of neurologic deficits.