Balloon Body

In Newark, N. J. last December a hit-&-run driver bashed into a pedestrian, bursting one of his lungs. So dramatic was the sudden ballooning of the victim's entire body that Dr. John Mahoney Atkinson, young house surgeon of Newark City Hospital, got special permission to publish a description of the phenomenon and how he cured it, in last week's issue of the American Journal of Surgery.

The accident broke five of the pedestrian's ribs, poking one of the ends into his right lung. At every breath he took, air leaked into the cavity of his chest. Shortly after Dr. Atkinson made the man comfortable, "it became apparent that the patient was literally blowing himself up more and more with each respiration. Within two-and-a-half hours of his admission [to the hospital], his appearance had changed entirely. From a moderately sized individual he had become an enormous, puffing, grunting balloon. His face became rounded; his neck so enlarged that his chin and chest were level; his arms, hands and even his fingertips were distended with air, and were tympanitic on percussion. His abdomen, legs and particularly his scrotum were greatly enlarged. The scrotum was about the size of a football and was tense and tympanitic. The patient's condition was obviously precarious. He became cyanotic, respirations became irregular and pulse weak."

Treatment proved simple. "A large-bore needle was inserted into the scrotum and air under pressure whistled out. The size of the scrotum did not change for some time, but it was noted that the swelling of the abdomen had somewhat decreased. It was found that the air under the skin of the legs, abdomen and chest could be gently massaged into the scrotum and thence out the needle. It was felt that the patient had a valve-like laceration of the lung. Therefore, a large bore needle was inserted into the right pleural space and a rubber tube connected to the butt. The free end of the tube was placed under water. It was found that air bubbled freely from the tube under water during expiration, and ceased during inspiration. Both needles were left in situ and the patient restrained."

Five days after the accident the hole in the man's lung closed. No more air escaped into his skin and Dr. Atkinson removed the air-venting needles. "The patient's recovery was slow but uneventful."

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