A Case of Spontaneous Extracranial Epidural Emphysema

Objective: To report a rare case of spontaneous extracranial epidural emphysema. Clinical Presentation and Intervention: An 18-year-old woman with a recent diagnosis of squamous cell carcinoma of the esophagus presented with acute onset of cough, dyspnea and subcutaneous emphysema. An esophageal endoscopy revealed an ulcerative lesion in the upper third of the esophagus that was diagnosed as squamous cell carcinoma. A computed tomographic scan of the chest showed spinal epidural emphysema in addition to pneumomediastinum and pneumoperitoneum. A few days later, the patient died of aspiration pneumonia and persistent epidural emphysema. Conclusion: The spontaneous extracranial epidural emphysema in our case resulted from a bout of cough with tracking of air from the pneumomediastinum through the emaciated tissue planes into the epidural space.