Pneumomediastinum
Every so often you encounter a patient that has a finding that catches you by surprise. Like having air in places that should not have air in them - Sean M. Fox MD
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HWN Suggests
Diagnosis and Treatment of Pneumomediastinum
Fortunately, SPM is an exceedingly rare and self-limiting disease...
Often, no significant interventions are required. While the course of treatment is not standardized, admission is generally recommended along with cardiothoracic or general surgery consultation. This is because of the need to rule out secondary causes that may require operative washout or repair of the aerodigestive tract. Bed rest and analgesia are often all the patient needs for recovery, with prophylactic antibiotics as a debated subject in the treatment algorithm. Complications are rare, and these patients often have an uneventful recovery course.
Featured
Spontaneous primary pneumomediastinum: is it always benign?
Spontaneous Pneumomediastinum is a rare disease. It could be a simple and self-limited condition or be a life-threatening complication of underlying diseases. The therapeutic options also differ by the cause.
Articles of Interest
A Case of Pneumomediastinum
Pneumomediastinum normally follows a benign course and is self-limiting.
A Case of the Incidentally Discovered Pneumomediastinum
Pneumomediastinum occurs when air infiltrates the mediastinal structures after a rupture of the esophagus, trachea, or lung. Sometimes it occurs spontaneously, with the cause never determined.
Annals of B-Pod: Spontaneous Pneumomediastinum
The epidemiology of pneumomediastinum largely depends on the underlying etiology and associated pathophysiology. Pneumomediastinum can be spontaneous or from a secondary cause. Predisposing conditions for spontaneous pneumomediastinum include smoking, asthma, idiopathic pulmonary fibrosis, and chronic obstructive pulmonary disease.
Pneumomediastinum Associated with Pneumopericardium and Epidural Pneumatosis
Spontaneous pneumomediastinum is a relatively rare benign condition. It may rarely be associated with one or combination of pneumothorax, epidural pneumatosis, pneumopericardium, or subcutaneous emphysema.
Pneumomediastinum: is this really a benign entity? When it can be considered as spontaneous?
Spontaneous pneumomediastinum is uncommon and is traditionally considered a benign, self-limited disorder that usually occurs in young adults without any apparent precipitating factor or disease.
Pneumomediastinum: Old Signs and New Signs
Pneumomediastinum can lead to pneumothorax, pneumopericardium, pneumoperitoneum, or pneumoretroperitoneum. There are many causes of pneumomediastinum.
Resources
emDocs
In children less than 6 years of age, spontaneous primary pneumomediastinum is very rare. For young kids, look more diligently for a cause of the pneumomediastinum. Asthma exacerbation is a common cause.
StatPearls
Once diagnosed and serious concomitant pathology excluded, management is largely focused on symptomatic treatment.
WestJEM
The most common presentation is nonspecific pleuritic chest pain with dyspnea. Potential life-threatening etiologies include esophageal rupture and tension pneumothorax, but these are historically evident at presentation.
