Oesophageal perforation: an unusual complication of a hypoglycaemic episode.

Daya, Hamid; Wijetunge, Don B.

doi:10.1136/emj.10.4.310

Cited by 2 publications

(2 citation statements)

References 5 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Older children presented with pleural effusion on CXR or were described as "gravely ill." Three case reports of adolescent patients describe the finding of mediastinal air discovered after vomiting that were treated conservatively. [10][11][12] Of note, an esophagram was not documented in 2 of the cases and was negative in the third. Without true confirmation of esophageal rupture, it is likely that these patients are more similar to the patients with spontaneous gastrointestinal-associated pneumomediastinum in our study than true Boerhaave syndrome.…”

Section: Discussionmentioning

confidence: 99%

“…Most were neonates. Older children presented with pleural effusion on CXR or were described as “gravely ill.” Three case reports of adolescent patients describe the finding of mediastinal air discovered after vomiting that were treated conservatively 10–12 . Of note, an esophagram was not documented in 2 of the cases and was negative in the third.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Management and Outcomes of Spontaneous Pneumomediastinum in Children

et al. 2019

View full text Add to dashboard Cite

Objectives: Management of spontaneous pneumomediastinum in the pediatric population is highly variable. There are limited data on the use of diagnostic tests and the need for admission. Our objectives were to characterize the management of pediatric spontaneous pneumomediastinum, determine the diagnostic yield of advanced imaging, and describe the patients' outcomes.Methods: This is a retrospective cohort study of all patients presenting to a single tertiary pediatric emergency department between January 2008 and February 2015 diagnosed with pneumomediastinum. Patients were identified using 2 complementary strategies: International Classification of Diseases, Ninth Revision billing codes and a keyword search of the hospital radiology database. Results:We identified 183 patients with spontaneous pneumomediastinum.The mean age was 12.8 ± 4.8 years. Diagnosis was established by chest radiograph (CXR) in 165 (90%) patients, chest computed tomography in 15 (8%), neck imaging in 2 (1%), and abdominal imaging in 1. After diagnosis, many patients underwent additional studies: repeat CXR (99, 54%), chest computed tomography (53, 29%), esophagram (45, 25%), and laryngoscopy (15, 8%). Seventy-eight percent of patients (n = 142) were admitted with a median length of stay of 27 hours (18.4-45.6 hours). Six patients returned to the emergency department within 96 hours for persistent chest pain; 2 were admitted, and 1 was found to have worsening pneumomediastinum on CXR. We performed a secondary analysis on 3 key subgroups: primary spontaneous pneumomediastinum (64, 35%), secondary gastrointestinalassociated pneumomediastinum (31, 17%), and secondary respiratoryassociated pneumomediastinum (88, 48%). No patients in the study received an invasive intervention for pneumomediastinum. In all patients, further studies did not yield additional diagnostic information.Conclusions: Our data suggest that patients with spontaneous pneumomediastinum who are clinically well appearing can be managed conservatively with clinical observation, avoiding exposure to radiation and invasive procedures.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%