Pneumomediastinum in Inflammatory Bowel Disease

Mihatov, Nino; Fenves, Andrew Z.

doi:10.1080/08998280.2015.11929270

Cited by 4 publications

(2 citation statements)

References 15 publications

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“…5 However, in this study, only a small amount of SPM patients had history of asthma or connective tissue diseases. 7,8 Similar with other SPM studies, a number of precipitating factors, such vigorous cough, exercise, sneezing, vomiting or retching, presented in our patients and these may lead to the increase in intrathoracic pressure resulting in pneumo-mediastinum. 9 Associated symptoms can be non-specific and many SPM patients can be relatively asymptomatic and physical signs may be absent.…”

Section: Discussionsupporting

confidence: 86%

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Spontaneous pneumo‐mediastinum ‐ A benign rarity?

Wong

Leung

et al. 2022

Surgical Practice

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Background: Spontaneous pneumo-mediastinum (SPM) is defined as the spontaneous occurrence of free gas in the mediastinum. Although SPM is rare, this is a unique differential cause for pneumo-mediastinum. It bears a benign clinical course with good clinical outcome, unlike others potentially life threatening causes of pneumomediastinum, such as oesophageal perforation and necrotizing mediastinitis. Methods and Results:A retrospective study about SPM was conducted in the Department of Surgery, Tuen Mun Hospital, HKSAR. SPM cases were retrieved through hospital's electronic records from 7/2000 to 6/2020. Patients' demographic data, clinical presentation, management and outcomes were reviewed. One hundred five SPM patients were retrieved with mean age 21.3 (0-68). More than 85% (91 cases) of them were younger age group (younger than the age of 30). Eightyseven cases (82.9%) were male while 18 cases (17.1%) were female. The top 3 presentation symptoms were: chest pain (69 cases, 65.7%), neck pain (43 cases, 41%) and sore throat (42 cases, 40%). Physical examination revealed surgical emphysema in 63 patients (60%). 61 (58.1%) patients enjoyed good past health and without any potential predisposing factors. Common precipitating factors included: vigorous cough (28 cases, 26.7%), vigorous exercise (16 cases, 15.2%), sneezing (15 cases, 14.3%) and vomiting/retching (14 cases, 13.3%).CXR showed pneumo-mediastinum in 98 cases (93.3%). Additional investigations, such as CT neck/thorax/abdomen with contrast (63 cases, 60%) and oesophagogastro-duodenoscopy (OGD) (29 cases, 27.6%), were performed to rule out other differential diagnosis in suspicious cases.All the SPM patients were treated conservatively (e.g. bed rest, analgesics, antibiotics, oxygen supplement). None of them required operative treatment with recurrence rate 0%. Average length of hospital stay was 4.1 days (1-35 days). Two out of 105 cases (1.9%) resulted in hospital mortality due to other underlying medical illnesses. Conclusion:SPM is an uncommon disease, mainly affecting the younger age group.Although SPM carries a benign and good clinical outcome, it is essential to exclude other potential life threatening conditions with similar presentations.

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Section: Discussionsupporting

confidence: 86%

“…Therefore, some investigators further classified SPM into (1) primary SPM, if there is no underlying lung disease, or (2) secondary SPM, if there is underlying airway disease, such as cystic fibrosis or asthma 5 . However, in this study, only a small amount of SPM patients had history of asthma or connective tissue diseases 7,8 …”

Section: Discussionmentioning

confidence: 84%

Spontaneous pneumo‐mediastinum ‐ A benign rarity?

Wong

Leung

et al. 2022

Surgical Practice

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Airway and lung involvement in inflammatory bowel disease

Camus¹,

Colby²

2019

Pulmonary Manifestations of Systemic Diseases

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A rare complication of acute severe ulcerative colitis

Dias¹,

Coelho²,

Nunes³

et al. 2021

AGEB

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A 21-year-old female with ulcerative colitis presented with abdominal pain and bloody diarrhea. Laboratory studies revealed markedly elevated C-reactive protein and thrombocytosis. Flexible sigmoidoscopy revealed severe endoscopic activity with ulceration and spontaneous bleeding along rectum and sigmoid colon. Ulcerative colitis had been diagnosed 3 years before, presenting as severe and extensive disease (pancolitis). She had previously failed therapy with infliximab and vedolizumab and had recently started induction therapy with golimumab. She responded well to intravenous corticosteroids but, when switched to oral corticosteroids, there was symptomatic recurrence. Intravenous corticosteroids were re-started and she was evaluated for surgery. At this time, she developed new-onset tachycardia. Electrocardiogram revealed sinus tachycardia with heart rate of approximately 120 bpm. Because tachycardia could result from worsening colitis with potential serious complications, abdominal computerized tomography scan was performed and demonstrated mild lumen dilation and wall thickening consistent with acute colitis without evidence of pneumoperitoneum or toxic megacolon. Surprisingly, thoracic planes revealed the presence of free air dissecting mediastinal space (Figure 1). What is your diagnosis?

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Pneumomediastinum in Inflammatory Bowel Disease

Cited by 4 publications

References 15 publications

Spontaneous pneumo‐mediastinum ‐ A benign rarity?

Spontaneous pneumo‐mediastinum ‐ A benign rarity?

Airway and lung involvement in inflammatory bowel disease

A rare complication of acute severe ulcerative colitis

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