Clinically significant pulmonary barotrauma after inflation of party balloons

doi:10.1136/bmj.313.7072.1619

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Andrew D Mumford, senior house officera,
Keyoumars Ashkan, house officera,
Stuart Elborn, consultant physicianb

^a Department of Medicine, University Hospital of Wales, Cardiff CF4 4XN
^b Respiratory Investigation, Level 11, Belfast City Hospital, Belfast BT9 7AB

Correspondence to: Dr Elborn.

Although pneumothorax is the commonest presentation of pulmonary barotrauma unrelated to mechanical ventilation, systemic air embolism and emphysema within the pulmonary interstitium, mediastinum, retroperitoneum, pericardium, and subcutaneous tissues have all been described.1 We report a case of pulmonary barotrauma after inflation of party balloons.

Case report

A 24 year old previously healthy, non-smoker presented with a 48 hour history of a sensation of crackling under the skin. His symptoms were initially confined to the neck but within 24 hours had affected his chest wall, trunk, and legs. The next day he developed retrosternal pleuritic chest pain and attended the accident and emergency department. He reported that 24 hours before the onset of symptoms he had inflated about 20 party balloons over one hour. He had not experienced chest pain or shortness of breath at the time or immediately afterwards. …