case_images: PMC6849119_01
case_images: Coronal and sagital reformat view of chest show pneunomomediatinum and emphysema in cervical space.
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case_images: CT-scan of neck and thorax showed: pneunomomediastinum and emphysema in cervical space, extensive subcutaneous emphysema of the neck, around the right ramus of the mandible and right masseter muscle that extended into the left side of the neck and tracked down into the anterior mediastinum (Fig. 1).
case_images: Axial lung and mediastinal window CT scan, show loculated pleural effusion and pleural enhancement due to empyema in right hemi thorax.
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case_images: Computed tomography of thorax also revealed bilateral pleural effusion, more predominant at right side with loculated empyema. Cervical and dorsal vertebrae were intact (Fig. 2).
case_images: Axial lung and mediastinal window CT Scan, after 18 days show loculated empyema left hemi thorax with pericardial thickening (7 mm) after 18 day the first operation.
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case_images: Bed side echocardiography showed pericardial thickening and effusion, repeated chest CT scan showed loculated empyema in left side with pericardial thickening (7 mm) without massive effusion or tamponade (Fig. 3).