Spontaneous Pneumomediastinum on Bedside Ultrasound: Case Report and Review of the Literature

Abstract

Spontaneous pneumomediastinum is a rare disease process with no clear etiology, although it is thought to be related to changes in intrathoracic pressure causing chest pain and dyspnea. We present a case of a 17-year-old male with acute chest pain evaluated initially by bedside ultrasound, which showed normal lung sliding but poor visualization of the parasternal and apical cardiac views due to significant air artifact, representing air in the thoracic cavity. The diagnosis was later verified by chest radiograph. We present a case report on ultrasound-diagnosed pneumomediastinum, and we review the diagnostic modalities to date.

Primary pneumomediastinum in a young woman with near fatal asthma. Diagnosis by ultrasound: a case report

“…When we speak exclusively of pneumopericardium we must find mainly two characteristics in the ultrasound that are the presence of comet tails that starts from the parietal pericardium and, the cyclic disappearance of the heart in some points during the systole. [8][9][10] As we can see, both the pneumomediastinum and the pneumopericardium share some echographic similarities, except that they show inclusion in the pericardial space as such air bubbles. In the case of hydropneumopericardium the presence of bright bubbles in the pericardial space that have the same cyclic disappearance characteristics are described.…”

Idiopathic pneumomediastinum – case report and review of the literature

“…Once pneumomediastinum is suspected, the diagnosis can be confirmed by chest radiograph (3,5,11,12). If the chest radiograph is diagnostic of pneumomediastinum and there is no risk of perforated intrathoracic viscus, no further investigations are required.…”

Subcutaneous Emphysema and Pneumomediastinum in 2 Years Old Children with Pierre Robin Syndrome: Multi-Disciplinary Management in an Emergency Department

“…Spontaneous pneumomediastinum (SPM) is an uncommon disease defined by the presence of free air in the mediastinal cavity [1][2][3]. Reported for the first time by Hammam [4], SPM is an uncommon disorder with an incidence less than 1:44.000 [2,5]; among emergency room visits the frequency calculated is 0.0025% [1,6,7].…”

“…Reported for the first time by Hammam [4], SPM is an uncommon disorder with an incidence less than 1:44.000 [2,5]; among emergency room visits the frequency calculated is 0.0025% [1,6,7].…”

“…Pneumomediastinum is considered spontaneous when there is no defined etiology; it is called secondary when consequent by a specific causative event, for example a trauma (posttraumatic pneumomediastinum), that is estimated as the most common known etiologic cause of pneumomediastinum [2]. The pathogenesis of SPM is characterized by all the processes that cause a sudden increase of intrathoracic pressure.…”