Pulmonary Barotrauma Including Huge Pulmonary Interstitial Emphysema in an Adult with Status Asthmaticus: Diagnostic and Therapeutic Challenges.

We describe ventilation-induced tension pulmonary interstitial emphysema combined with contralateral pneumothorax, pneumomediastinum, pneumoperitoneum and subcutaneous emphysema which developed immediately after difficult airway management of acutely decompensated asthma in an adult.The present case highlights the importance of crash induction, cautious airway management and protective re-ventilation in the management of acute respiratory failure with dynamic hyperinflation, such as status asthmaticus.Minimally invasive management by percutaneous trans-thoracic intrabullous chest-tube drainage is feasible, safe and relatively effective.