Spontaneous pneumomediastinum: Time for consensus

Sahni, Sonu; Verma, Sameer; Grullon, Jinette; Esquire, Anthony; Patel, Purvesh; Talwar, Arunabh

doi:10.4103/1947-2714.117296

Cited by 132 publications

(99 citation statements)

References 18 publications

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“… 1 - 3 It was first described by Louis Hamman in 1939, which is why it is also known as Hamman's syndrome. 1 , 2 , 4 - 7 However, secondary pneumomediastinum had previously been reported as a traumatic complication, by René Laennec in 1819.…”

Section: Introductionmentioning

confidence: 99%

Spontaneous pneumomediastinum: experience in 18 patients during the last 12 years

et al. 2017

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Objective:To characterize clinically all of the patients with spontaneous pneumomediastinum (SPM) admitted to an adult pulmonology ward in Lisbon, Portugal. Methods: This was a retrospective descriptive study of all adult patients (≥ 18 years of age) diagnosed with SPM between January of 2004 and September of 2015. Results: At least one predisposing factor was identified in most (88.9%) of the 18 patients who presented with SPM during the study period. With regard to precipitating factors, bouts of cough were present in 50.0% of the patients. Other precipitating factors included a sudden increase in tobacco consumption, inhaled drug use, occupational inhalation of varnish fumes, intense exercise, and vomiting. The most common complaints were dyspnea (in 83.3%) and chest pain (in 77.8%). Other complaints included cough, neck pain, dysphagia, and odynophagia. Subcutaneous emphysema was found in most of the patients. The diagnosis of SPM was based on chest X-ray findings in 61.1% of the patients. Conclusions: Although SPM is a rare condition, it should be considered in the differential diagnosis of chest pain and dyspnea. It can develop without a triggering event or conclusive findings on a chest X-ray, which is usually sufficient for diagnosis.

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Section: Introductionmentioning

confidence: 99%

Spontaneous pneumomediastinum: experience in 18 patients during the last 12 years

et al. 2017

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“…The clinical symptoms of mediastinal and/or subcutaneous emphysema critically depend on the amount of extravasated gas and the degree of extension of the affected areas. Most frequently, they include swelling and crepitus over the involved anatomical site, as well as chest pain, dyspnoea, and dysphagia [1, 4]. …”

Section: Introductionmentioning

confidence: 99%

Diffuse Subcutaneous Emphysema and Pneumomediastinum Secondary to a Minor Blunt Chest Trauma

Storz

Heymann

Exadaktylos

2017

Case Reports in Emergency Medicine

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Full medical evaluation is paramount for all trauma patients. Minor traumas are often overlooked, as they are thought to bear low injury potential. In this case report, we describe the case of a 48-year-old man presenting to our Emergency Department with mild to moderate right-sided shoulder and scapular pain following a fall from his own height ten days previously. Clinical and paraclinical investigations (CT) revealed diffuse right shoulder pain, with crepitations on palpation of the neck, right shoulder, and right lateral chest wall. Computed tomography (CT) demonstrated right-sided costal fractures (ribs 7 to 9), with diffuse subcutaneous emphysema and pneumomediastinum due to laceration of the visceral and parietal pleura and the adjacent lung parenchyma. In addition, a small ipsilateral pneumothorax was found. Surprisingly, the clinical status was only minimally affected by mild to moderate pain and minor functional impairment.

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“…Traumatic pneumomediastinum is caused by blunt in around 86% or penetrating trauma in around 14% of cases [3] or by iatrogenic injury, such as that produced by mechanical ventilation or endoscopic procedures [4]. …”

Section: Introductionmentioning

confidence: 99%

Pneumomediastinum in Blunt Chest Trauma: A Case Report and Review of the Literature

Mansella

Bingisser

Nickel

2014

Case Reports in Emergency Medicine

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Blunt trauma is the most common mechanism of injury in patients with pneumomediastinum and may occur in up to 10% of patients with severe blunt thoracic and cervical trauma. In this case report we present a 24-year-old man with pneumomediastinum due to blunt chest trauma after jumping from a bridge into a river. He complained of persistent retrosternal pain with exacerbation during deep inspiration. Physical examination showed only a slight tenderness of the sternum and the extended Focused Assessment with Sonography for Trauma (e-FAST) was normal. Pneumomediastinum was suspected by chest X-ray and confirmed by computed tomography, which showed a lung contusion as probable cause of the pneumomediastinum due to the “Mackling effect.” Sonographic findings consistent with pneumomediastinum, like the “air gap” sign, are helpful for quick bedside diagnosis, but the diagnostic criteria are not yet as well established as for pneumothorax. This present case shows that despite minimal findings in physical examination and a normal e-FAST a pneumomediastinum is still possible in a patient with chest pain after blunt chest trauma. Therefore, pneumomediastinum should always be considered to prevent missing major aerodigestive injuries, which can be associated with a high mortality rate.

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Spontaneous pneumomediastinum: Time for consensus

Cited by 132 publications

References 18 publications

Spontaneous pneumomediastinum: experience in 18 patients during the last 12 years

Spontaneous pneumomediastinum: experience in 18 patients during the last 12 years

Diffuse Subcutaneous Emphysema and Pneumomediastinum Secondary to a Minor Blunt Chest Trauma

Pneumomediastinum in Blunt Chest Trauma: A Case Report and Review of the Literature

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