Pneumomediastinum and Bilateral Pneumothoraces in a Patient With Hyperemesis Gravidarum

Schwartz, Marlene; Rossoff, Leonard J.

doi:10.1378/chest.106.6.1904

Cited by 31 publications

(25 citation statements)

References 7 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…5 Known precipitating events include abuse of inhalational drugs such as crack cocaine, 10 acute asthma attacks, 11 coughing, vomiting, forceful straining during physical exercise, or other activities associated with a Valsalva-type maneuver such as straining in labor. 1,2,5,6,12,13 The mechanism of alveolar rupture in vomiting appears to be abdominal muscle contraction against a closed glottis, resulting in increased intra-alveolar pressure. 5 Most cases of Boerhaave's syndrome are associated with vomiting causing the intraluminal pressure of the esophagus to suddenly exceed the tensile strength of its wall.…”

Section: Discussionmentioning

confidence: 99%

“…1,2,5,6,12,13 The mechanism of alveolar rupture in vomiting appears to be abdominal muscle contraction against a closed glottis, resulting in increased intra-alveolar pressure. 5 Most cases of Boerhaave's syndrome are associated with vomiting causing the intraluminal pressure of the esophagus to suddenly exceed the tensile strength of its wall. 3 It is worth noting that vomiting can cause both alveolar and esophageal rupture and yet, while vomiting is common, both of these conditions are rare.…”

Section: Discussionmentioning

confidence: 99%

“…14 Both of these conditions are associated with a wide range of symptoms including retrosternal chest pain, cough, sore throat, dysphonia, dysphagia, palpitations, neck discomfort, and dyspnea. [1][2][3]5,6,15 In one series of 17 patients with spontaneous pneumomediastinum, 82% of patients presented with chest pain, dyspnea, or both, whereas 18% of patients presented with neck discomfort only. 4 In another series of 24 patients with spontaneous pneumomediastinum, the most common symptoms were chest pain, neck discomfort, and persistent cough.…”

Section: Discussionmentioning

confidence: 99%

“…4,5 Other less reliable signs include the extrapleural air sign, which is extrapleural displacement of the parietal pleura by air; the continuous diaphragm sign, which is the interposition of air between the heart and the diaphragm; and the thymic sail sign, which is elevation of the thymus by air. 5,17,18 Chest X-rays are abnormal in 90% of patients with Boerhaave's syndrome in whom additional signs include left pleural effusion, hydropneumothorax, and basal collapse and consolidation. 3,19 The V sign of Nacleiro, being radiolucent streaks of air passing along the aorta and diaphragm, may also be present.…”

Section: Discussionmentioning

confidence: 99%

“…1 Possible complications such as tension pneumothorax, tension pneumomediastinum, pneumopericardium, and air embolism are all rare. 1,2,5,15,2 . Similarly, recurrent symptoms appear to be uncommon.…”

Section: Discussionmentioning

confidence: 99%

See 4 more Smart Citations

Vomiting-Induced Pneumomediastinum and Subcutaneous Emphysema Does Not Always Indicate Boerhaave's Syndrome: Report of Six Cases

et al. 2007

View full text Add to dashboard Cite

Spontaneous pneumomediastinum is an uncommon, self-limiting condition resulting from alveolar rupture in young adults. Because of the ambiguous presentation and the general lack of awareness of this condition, its diagnosis is often delayed, missed, or confused with spontaneous esophageal perforation. We report our experience of treating six patients who were referred to our unit with vomiting-induced pneumomediastinum, subcutaneous emphysema, and an initial diagnosis of spontaneous esophageal perforation. Ultimately, we diagnosed spontaneous pneumomediastinum in all six patients, who recovered uneventfully without any surgical intervention. We review the literature with particular emphasis on differentiating spontaneous pneumomediastinum from spontaneous esophageal perforation.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

Vomiting-Induced Pneumomediastinum and Subcutaneous Emphysema Does Not Always Indicate Boerhaave's Syndrome: Report of Six Cases

et al. 2007

View full text Add to dashboard Cite

show abstract

Rapidly progressing case of Mounier‐Kuhn Syndrome in early childhood

Hubbard

Masters

Chang

2003

Pediatric Pulmonology

View full text Add to dashboard Cite

Reports of Mounier-Kuhn Syndrome in childhood are extremely rare, as it usually presents in the third or fourth decades. In the only other report of a case diagnosed in early childhood, the child was well at the time of publication. We report on a 15-month-old boy who presented with his first respiratory illness at age 3 months. His disease course was more severe than previously reported. Diagnosis was characteristically delayed until acute respiratory failure complicated a respiratory tract infection at 13 months, prompting high-resolution computerized tomography (HRCT) of the chest. He gradually deteriorated, eventually requiring ventilatory support; death occurred at age 15 months. This report illustrates the clinical heterogeneity of the syndrome. We review the theories about etiology and the recognized clinical findings in adults. Incidence may be higher than previously estimated, and tracheobronchomegaly (TBM) should be considered as a cause of respiratory failure and recurrent pneumonia in children where other investigations, including chest X-ray (CXR), are normal. A chest HRCT (cHRCT) scan and bronchoscopy are usually diagnostic.

show abstract

Spontaneous Pneumomediastinum: Experience in 18 Adult Patients

Mondello

Pavia

Ruggeri

et al. 2007

Lung

View full text Add to dashboard Cite

Spontaneous pneumomediastinum (SPM) is defined as the presence of air in the mediastinum, developing in the absence of traumatic, iatrogenic, or preceding pulmonary pathologies (emphysema, chronic bronchitis, and lung cancer). The aim of this study was to review our experiences with SPM, underlining its symptomatology, diagnosis, treatment, and followup, and defining a reasonable course of assessment and management. A retrospective case series was conducted to identify adult patients with SPM who were diagnosed and treated in our institution between 1998 and 2005. Eighteen patients (10 males) were identified (average age = 25 +/- 4.8 years). Acute onset of chest pain was the predominant symptom at presentation. All patients developed clinically evident subcutaneous emphysema and underwent chest computerized tomography. Fiber bronchoscopy and echocardiogram were used selectively (8 patients). The average hospital stay was 6 (+/-1.4) days. Sixteen patients were conservatively treated, and only two patients were treated with thoracic drainage due to a related pneumothorax. The disease followed a benign evolution in all patients and, as of today, no relapse has been reported. SPM is an uncommon pathology with a usually benign course. The authors discuss SPM. A diagnostic algorithmic approach is necessary to rule out severe secondary entities and consequences that need urgent treatment.

show abstract

Pneumomediastinum and Bilateral Pneumothoraces in a Patient With Hyperemesis Gravidarum

Cited by 31 publications

References 7 publications

Vomiting-Induced Pneumomediastinum and Subcutaneous Emphysema Does Not Always Indicate Boerhaave's Syndrome: Report of Six Cases

Vomiting-Induced Pneumomediastinum and Subcutaneous Emphysema Does Not Always Indicate Boerhaave's Syndrome: Report of Six Cases

Rapidly progressing case of Mounier‐Kuhn Syndrome in early childhood

Spontaneous Pneumomediastinum: Experience in 18 Adult Patients

Contact Info

Product

Resources

About