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Vol. 36. Issue 1.
Pages 52-54 (January 2000)
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Vol. 36. Issue 1.
Pages 52-54 (January 2000)
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Fractura de hioides y enfisema cervical subcutáneo traumático por intento de ahorcamiento. A propósito de un caso
Hyoid bone fracture and subcutaneous emphysema due to trauma from attempted hanging: a case report
Visits
24417
M.A. Cañizares*, A. Arnau, A. Fortea, V. Zarzuela, P. Martínez-Vallina, A. Cantó
Servicio de Cirugía Torácica. Hospital General Universitario. Valencia
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Presentamos el caso de un paciente con antecedentes psiquiátricos que, tras un intento de autólisis mediante ahorcamiento, fue remitido a nuestro centro. Se apreciaba un gran enfisema subcutáneo facial, palpebral y cervical, con disfonía, disfagia y discreta dificultad respiratoria. La fibrobroncoscopia demostró obstrucción de las vías altas por edema, con integridad de la vía aérea. Varias TAC cervicales sucesivas evidenciaron, además del enfisema subcutáneo y el neumomediastino correspondiente, la existencia de una fractura de hioides, así como la existencia de un laringocele. Ante la persistencia de la disfagia, se realizaron pruebas de función esofágica, demostrándose una alteración funcional del esfínter esofágico superior. Una cervicotomía suprasternal, para el drenaje del neumomediastino, y una microcirugía laríngea, para el tratamiento el laringocele, solucionaron el problema.

Palabras clave:
Enfisema subcutáneo
Fractura de hioides
Disfagia

We describe a patient with a history of psychiatric disorder who was brought to our hospital after attempted suicide by hanging. Severe subcutaneous facial, palpebral and cervical emphysema was present, with dysphonia, dysphagia and slight respiratory difficulty. Fiberoptic bronchoscopy revealed upper airway obstruction due to edema in an intact airway. Successive CAT scans gave evidence of hyoid fracture and laryngocele, in addition to the corresponding emphysema of the subcutaneous area and pneumomediastinum. Given the persistence of dysphagia, we ordered esophageal tests, which showed functional alteration of the upper esophageal sphincter. Suprasternal cervicotomy to drain the pneumomediastinum and laryngeal microsurgery to treat the laryngocele resolved the problem.

Key words:
Subcutaneous emphysema
Hyoid fracturel Dysphagia
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