Spectrum of barotraumatic events in COVID-19 patients on high-resolution computed tomography

Abstract

Barotrauma has many different presentations, including pneumothorax, subcutaneous emphysema, pneumoperitoneum, and pneumomediastinum. We have presented and analyzed some interesting cases of barotrauma in this case series. Case 1 in our series developed a thin-walled new cavity due to barotrauma, mimicking pneumatocele and fungal cavity. Case 2 presented with coexistence of pneumothorax and cavity with fungal infestation. Severity of barotrauma due to positive pressure ventilation has been shown in case 3. An interesting case of barotrauma in a 36-week primigravida, post cesarean section, causing dehiscence of scar, presented as case 4 in our series. Early and rapid imaging diagnosis of barotrauma should be pursued. In patients with mechanical ventilation, identifying small changes in imaging characteristics of cavitary lesions, such as fungal, bacterial, or transient cavities, would aid physicians in offering a correct treatment plan.

Keywords

• barotrauma
• mechanical ventilation
• pneumomediastinum
• pneumothorax
• subcutaneous emphysema