Fatal subcutaneous emphysema by manja: a deadly string

Kite-string injuries: A case series

Kites are very popular in India. Over the years, both kite-flying and kite-making skills have evolved. The conventional cotton threads that were used as kite string (manja) have been replaced by much cheaper and stronger Chinese manja, which is based on nonbiodegradable synthetic fibers. It is hard to break and has caused a sudden surge in dangerous kite string-related injuries. There are a lot of injuries usually sustained by kite-flyers, two-wheeler riders, and pedestrians. Very few case reports and case series have shown injuries related to flying a kite, which range from laceration of hand to fatal throat injuries. Secondary impact injuries attributed to kite string (manja) are rarely reported in the medical literature. We present a series of four cases with special emphasis on a patient, who sustained secondary impact injury with fatal outcome. Emergency physician should know that these trivial looking injuries can be associated with significant neck injuries. They can also cause significant secondary impact injuries.

A case report of tardive subcutaneous emphysema in relation to iatrogenic pneumothorax

Subcutaneous emphysema, the presence of air under the subcutaneous tissues, often arises in relation to pneumothorax, including iatrogenic pneumothorax. It can arise as a consequence of chest drain insertion and removal. This case report describes worsening of subcutaneous emphysema subsequent to chest drain removal, leading to tardive and life-threatening subcutaneous emphysema. There are few international guidelines describing chest drain removal and there are few reports describing tardive subcutaneous emphysema. These areas need further exploration using evidence-based research in order to develop a consensus on treatment options.