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João EPE, Porto. Dr. Amadeu Pimenta" "etiqueta" => "<span class="elsevierStyleSup">3</span>" "identificador" => "aff0015" ] 3 => array:3 [ "entidad" => "Assistente Hospitalar Graduado de Cirurgia Geral, Serviço de Pneumologia do Hospital de S. João EPE, Porto Dr. Amadeu Pimenta" "etiqueta" => "<span class="elsevierStyleSup">4</span>" "identificador" => "aff0020" ] 4 => array:3 [ "entidad" => "Chefe de Serviço de Pneumologia, Director do Serviço de Pneumologia" "etiqueta" => "<span class="elsevierStyleSup">5</span>" "identificador" => "aff0025" ] 5 => array:3 [ "entidad" => "Serviço de Pneumologia do Hospital de S. João EPE, Porto Director: Prof" "etiqueta" => "<span class="elsevierStyleSup">6</span>" "identificador" => "aff0030" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Alameda Prof. Hernâni Monteiro 4200 – Porto." ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Massive subcutaneous emphysema – Management using subcutaneous drains" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2009-07-09" "fechaAceptado" => "2009-09-08" "PalabrasClave" => array:2 [ "pt" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palavras-chave" "identificador" => "xpalclavsec160712" "palabras" => array:3 [ 0 => "Enfisema subcutâneo" 1 => "dreno subcutâneo" 2 => "tratamento" ] ] ] "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key-words" "identificador" => "xpalclavsec160713" "palabras" => array:3 [ 0 => "Subcutaneous emphysema" 1 => "subcutaneous drain" 2 => "management" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "pt" => array:2 [ "titulo" => "Resumo" "resumen" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">O enfisema subcutâneo é uma complicação relativamente comum na sequência de técnicas invasivas, procedimentos cirúrgicos e algumas patologias médicas. Na maior parte dos casos apenas causa sintomatologia <span class="elsevierStyleItalic">minor</span> e o tratamento é habitualmente conservador. Mesmo quando grave, raramente tem consequências patofisiológicas significativas, apesar de ser extremamente desconfortável para o doente.</p><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Os autores descrevem um caso clínico de enfisema subcutâneo maciço, de rápida instalação, após saída acidental de tubo de drenagem torácica, em doente com pneumotórax espontâneo secundário e fístula broncopleural. O enfisema foi tratado através da colocação, sob anestesia local, de dois drenos subcutâneos na parede anterossuperior do tórax, conectados a sacos de drenagem. Após a colocação dos drenos subcutâneos verificou-se uma franca melhoria clínica do doente, com descompressão eficaz do enfisema subcutâneo. No presente caso clínico, a técnica de drenagem do enfisema maciço mostrou-se simples, segura e eficaz, permitindo o alívio sintomático imediato.</p>" ] "en" => array:2 [ "titulo" => "Abstract" "resumen" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Massive subcutaneous emphysema is a relatively common complication in invasive techniques, surgical practice and some medical conditions. Subcutaneous emphysema is usually treated conservatively and may only cause minimal symptoms. Even when it is severe, subcutaneous emphysema rarely has pathophysiologic consequences, but it is extremely uncomfortable for the patient.</p><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">The authors report a case of massive and rapid developing subcutaneous emphysema following chest tube displacement in a patient with spontaneous se- condary pneumothorax and large air leak. The emphysema was treated with two subcutaneous drains, inserted using local anesthesia, on both sides of the chest (antero-superior thoracic wall), connected to drainage bags. The drains produced a dramatic clinical improvement and provided effective decompression of the subcutaneous emphysema.</p><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">In this clinical case, the technique of drainage of severe subcutaneous emphysema using subcutaneous drains was safe, easy and effective, affording immediate symptom relief.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "Bibliografia" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:25 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1." 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Original language: Portuguese
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