{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T08:10:04Z","timestamp":1756368604244,"version":"3.44.0"},"reference-count":14,"publisher":"BMJ","issue":"4","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2024,4,10]]},"published-print":{"date-parts":[[2024,4]]},"abstract":"<jats:p>A man in his 30s presented to the emergency department with a history of injury to the face with a crowbar. He was discharged from the department, in the absence of any facial bone fractures and given normal examination findings, except for a puncture wound on the mentum. The patient then re-presented within 24 hours with extensive cervical emphysema extending into the mediastinal cavity.<\/jats:p>\n               <jats:p>He was referred to ear, nose and throat team for further management. CT scan of the chest and neck showed extensive surgical emphysema and a pneumomediastinum. The patient was managed conservatively and recovered well with no significant sequelae.<\/jats:p>\n               <jats:p>Even in the absence of facial bone fractures, it is imperative to understand the force of impact which should prompt a consideration of imaging of the chest. Appropriate advice regarding avoidance of Valsalva manoeuvres will help prevent extensive propagation of air through the fascial planes that can result in a pneumomediastinum.<\/jats:p>","DOI":"10.1136\/bcr-2022-252705","type":"journal-article","created":{"date-parts":[[2024,4,22]],"date-time":"2024-04-22T12:35:20Z","timestamp":1713789320000},"page":"e252705","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Trivial trauma to the cheek: significant complications in the chest"],"prefix":"10.1136","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3625-2237","authenticated-orcid":false,"given":"Priyanka","family":"Shastri","sequence":"first","affiliation":[{"name":"ENT, Aneurin Bevan Health Board, Newport, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6268-2882","authenticated-orcid":false,"given":"Edgardo","family":"Abelardo","sequence":"additional","affiliation":[{"name":"ENT-HNS, Hywel Dda University Health Board, Carmarthen, UK"},{"name":"Institute of Life Sciences 2, Swansea University Medical School, Swansea, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vinod","family":"Prabhu","sequence":"additional","affiliation":[{"name":"Hywel Dda University Health Board, Carmarthen, Carmarthenshire, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2024,4,22]]},"reference":[{"key":"2025082800512116000_17.4.e252705.1","doi-asserted-by":"crossref","first-page":"253","DOI":"10.1002\/ams2.109","article-title":"Iatrogenic subcutaneous emphysema and pneumomediastinum following a high-speed air drill dental treatment procedure","volume":"2","author":"Nishimura","year":"2015","journal-title":"Acute Medicine & Surgery"},{"key":"2025082800512116000_17.4.e252705.2","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1016\/0030-4220(58)90053-7","article-title":"Surgical emphysema of the face following a middle third fracture","volume":"11","author":"STOCKDALE","year":"1958","journal-title":"Oral Surg Oral Med Oral Pathol"},{"key":"2025082800512116000_17.4.e252705.3","doi-asserted-by":"crossref","first-page":"192","DOI":"10.1016\/j.ajem.2016.06.090","article-title":"Pneumomediastinum secondary to facial trauma","volume":"35","author":"Hong","year":"2017","journal-title":"Am J Emerg Med"},{"key":"2025082800512116000_17.4.e252705.4","doi-asserted-by":"publisher","DOI":"10.1016\/S0736-4679(00)00179-7"},{"key":"2025082800512116000_17.4.e252705.5","first-page":"22","article-title":"Severe cervicofacial emphysema and pneumomediastinum caused by a dental handpiece: a case report and guidelines for management for the dental practitioner","volume":"82","author":"Ban","year":"2016","journal-title":"N Y State Dent J"},{"key":"2025082800512116000_17.4.e252705.6","doi-asserted-by":"crossref","first-page":"72","DOI":"10.1177\/1943387521997236","article-title":"Pneumomediastinum as a complication of oral and maxillofacial injuries: report of 3 cases and a 50-year systematic review of case reports","volume":"15","author":"Papadiochos","year":"2022","journal-title":"Craniomaxillofac Trauma Reconstr"},{"key":"2025082800512116000_17.4.e252705.7","doi-asserted-by":"publisher","DOI":"10.1097\/00006565-199706000-00008"},{"key":"2025082800512116000_17.4.e252705.8","doi-asserted-by":"crossref","first-page":"182","DOI":"10.1136\/emj.19.2.182","article-title":"Mediastinal emphysema after a minor oral laceration","volume":"19","author":"Abdulla","year":"2002","journal-title":"Emerg Med J"},{"key":"2025082800512116000_17.4.e252705.9","doi-asserted-by":"crossref","first-page":"1213","DOI":"10.4103\/njcp.njcp_3_16","article-title":"Spontaneous retropharyngeal emphysema: a case report","volume":"20","author":"Chi","year":"2017","journal-title":"Niger J Clin Pract"},{"key":"2025082800512116000_17.4.e252705.10","doi-asserted-by":"crossref","unstructured":"Ohara G , Kagohashi K , Aoyagi Y , et al . Hoarseness due to subcutaneous emphysema and pneumomediastinum. 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