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Spontaneous Pneumomediastinum: An Unusual Pulmonary Complication in Anorexia Nervosa

  • Lee, Kyung-Jin (Department of Internal Medicine, Inje University Sanggye Paik Hospital, Inje University College of Medicine) ;
  • Yum, Ho-Kee (Department of Internal Medicine, Inje University Sanggye Paik Hospital, Inje University College of Medicine) ;
  • Park, I-Nae (Department of Internal Medicine, Inje University Sanggye Paik Hospital, Inje University College of Medicine)
  • Received : 2015.02.04
  • Accepted : 2015.04.09
  • Published : 2015.10.30

Abstract

Spontaneous pneumomediastinum (PM) is an uncommon condition in which free air enters the mediastinum. This usually occurs either through esophageal tears after vigorous vomiting, or after alveolar rupture subsequent to a rapid increase in intra-alveolar pressure. Spontaneous PM is a rare entity in anorexia nervosa (AN) and self-induced vomiting is often the cause of PM in patients with AN. We experienced a case of spontaneous PM in an anorexic adolescent, in whom vomiting was not the cause of PM.

Keywords

References

  1. Murayama S, Gibo S. Spontaneous pneumomediastinum and Macklin effect: overview and appearance on computed tomography. World J Radiol 2014;6:850-4. https://doi.org/10.4329/wjr.v6.i11.850
  2. Al-Mufarrej F, Badar J, Gharagozloo F, Tempesta B, Strother E, Margolis M. Spontaneous pneumomediastinum: diagnostic and therapeutic interventions. J Cardiothorac Surg 2008;3:59. https://doi.org/10.1186/1749-8090-3-59
  3. Macia I, Moya J, Ramos R, Morera R, Escobar I, Saumench J, et al. Spontaneous pneumomediastinum: 41 cases. Eur J Cardiothorac Surg 2007;31:1110-4. https://doi.org/10.1016/j.ejcts.2007.03.008
  4. Overby KJ, Litt IF. Mediastinal emphysema in an adolescent with anorexia nervosa and self-induced emesis. Pediatrics 1988;81:134-6.
  5. Folsom T, Realmuto G. Pneumomediastinum in an adolescent female with anorexia nervosa. Int J Eat Disord 1984;3:67-70. https://doi.org/10.1002/1098-108X(198422)3:4<67::AID-EAT2260030408>3.0.CO;2-O
  6. van Veelen I, Hogeman PH, van Elburg A, Nielsen-Abbring FW, Heggelman BG, Mahieu HF. Pneumomediastinum: a rare complication of anorexia nervosa in children and adolescents: a case study and review of the literature. Eur J Pediatr 2008;167:171-4. https://doi.org/10.1007/s00431-007-0444-9
  7. Lin LY, Kwok CF, Tang KT, Ho LT, Lin HD. Diffuse soft tissue emphysema in anorexia nervosa: a case report. Int J Eat Disord 2005;38:277-80. https://doi.org/10.1002/eat.20170
  8. Filosso PL, Garabello D, Lyberis P, Ruffini E, Oliaro A. Spontaneous pneumomediastinum: a rare complication of anorexia nervosa. J Thorac Cardiovasc Surg 2010;139:e79-80. https://doi.org/10.1016/j.jtcvs.2008.04.037
  9. Goldstein MA, Herzog DB, Misra M, Sagar P. Case records of the Massachusetts General Hospital. Case 29-2008. A 19-year-old man with weight loss and abdominal pain. N Engl J Med 2008;359:1272-83. https://doi.org/10.1056/NEJMcpc0804641
  10. Adson DE, Crow SJ, Mitchell JE. Spontaneous pneumothorax in anorexia nervosa. Psychosomatics 1998;39:162-4. https://doi.org/10.1016/S0033-3182(98)71363-5
  11. Corless JA, Delaney JC, Page RD. Simultaneous bilateral spontaneous pneumothoraces in a young woman with anorexia nervosa. Int J Eat Disord 2001;30:110-2. https://doi.org/10.1002/eat.1061
  12. Fergusson RJ, Shaw TR, Turnbull CM. Spontaneous pneumomediastinum: a complication of anorexia nervosa? Postgrad Med J 1985;61:815-7. https://doi.org/10.1136/pgmj.61.719.815
  13. Coxson HO, Chan IH, Mayo JR, Hlynsky J, Nakano Y, Birmingham CL. Early emphysema in patients with anorexia nervosa. Am J Respir Crit Care Med 2004;170:748-52. https://doi.org/10.1164/rccm.200405-651OC
  14. Massaro D, Massaro GD, Baras A, Hoffman EP, Clerch LB. Calorie-related rapid onset of alveolar loss, regeneration, and changes in mouse lung gene expression. Am J Physiol Lung Cell Mol Physiol 2004;286:L896-906. https://doi.org/10.1152/ajplung.00333.2003
  15. Winick M. Hunger disease: studies by the Jewish physicians in the Warsaw Ghetto. New York: Wiley; 1979. p. 221-3.

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