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Clinical Analysis of Spontaneous Pneumomediastinum  

Chon Soon-Ho (Department of Thoracic and Cardiovascular Surgery, Hanyang University Guri Hospital)
Wee Jang Seop (Department of Thoracic and Cardiovascular Surgery, Hanyang University Hospital)
Lee Chul Burm (Department of Thoracic and Cardiovascular Surgery, Hanyang University Guri Hospital)
Kim Hyuck (Department of Thoracic and Cardiovascular Surgery, Hanyang University Hospital)
Kim YoungHak (Department of Thoracic and Cardiovascular Surgery, Hanyang University Hospital)
Publication Information
Journal of Chest Surgery / v.39, no.1, 2006 , pp. 56-59 More about this Journal
Abstract
Background: Spontaneous pneumomediastinum (SPM) is a relatively rare and benign condition that generally occurs in young adults without any precipitating factor or disease. The purpose of this study was to assess whether more uncomforting diagnostic procedures are necessary and to establish standards in the diagnosis and treatment of spontaneous pneumomediastinum. Material and Method: A retrospective study was done on 18 patients from the hospitals of Hanyang University Seoul Hospital and Hanyang University Guri Hospital between February, 1997 and June, 2004. All patients had presence of mediastinal air without a pneumothorax and no evidence of trauma or barotrauma. Result: Among the 18 patients, the majority were male patients with only two female patients. Their mean age was 20.95 years old with standard deviation of 14.3 years. The most common complaints were chest pain, dyspnea, and coughing. Evaluation included simple chest roentgenogram in all patients, 10 patients had a chest tomographic scan, 10 patients had an esophagoscopic exam, 6 patients had a bronchofiberoscopic exam, and 3 patients had an esophagogram done. The mean hospital stay was 10.9 days. All patients were treated conservatively and in a follow-up of 1 $\∼$ 8 years only one recurrence was found. Conclusion: SPM is caused by alveolar rupture in the pulmonary interstitium leading to dissection of air towards the hilum and mediastinum. Although SPM is a self-limiting condition, evaluation should include chest roentgenogram and chest tomographic scans to rule out any other secondary condition. More aggressive evaluation seems unnecessary.
Keywords
Pneumomediastinum; Mediastinal emphysema; Emphysema;
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1 Hamman L. Spontaneous mediastinal emphysema. Bull Johns Hopkins Hosp. 1939;64:1-21
2 Chalumeau M, Le Clainche L, Sayeg N, et al. Spontaneous pneumomediastinum in children. Pediatric Pulmonology 2001; 31:67-75   DOI   ScienceOn
3 Chapdelaine J, Beaunoyer M, Daigneault P, et al. Spontaneous pneumomediastinum: Are we overinvestigating? J Ped Surg 2004;39:681-4   DOI   ScienceOn
4 Sikdar T, Macvivar D, Husband JE. Pneumomediastinum complicating bleomycin related lung damage. Br J Radiol 1998; 71:1202-4   DOI
5 Gerazounis M, Athanassiadi K, Kalantzi N, Moustardas M. Spontaneous pneumomediastinum: A rare benign entitiy. J Thorac Cardiovasc Surg 2003;126:188-91
6 Jougan JB, Ballester M, Delcambre F, MacBride T, Drower CE, Velly JF. Assessment of spontaneous pneumomediastinum: experience with 12 patients. Ann Thorac Surg 2003;75: 1711-4   DOI   ScienceOn
7 Kaneki T, Kubo K, Kawashima A, Koizumi T, Sekiguchi M, Sone S. Spontaneous pneumomediastinum in 33 patients: Yield of chest computed tomography for the diagnosis of the mild type. Respiration 2000;67:408-11   DOI   ScienceOn
8 Koullias GJ, Korkolis DP, Wang XJ, Hammond GL. Current assessment and management of spontaneous pneumomediastinum: experience in 24 adult patients. Eur J Cardiothorac Surg 2004;25:852-5   DOI   ScienceOn
9 Yellin A. Gapany-Gapanavicius M, Lieberman Y. Spontaneous pneumomediastinum: is it a rare cause of chest pain? Thorax 1983;38:383-5   DOI
10 Jamadar DA, Kazerooni EA, Hirschl RB. Pneummediastinum: Elucidation of the anatomic pathway by liquid ventilation. J Comp Assist Tomog 1996;20:309-11   DOI   ScienceOn
11 Abolnik I, Lossos IS, Breuer R. Spontaneous pneumomediastinum. A report of 25 cases. Chest 1991;100:93-5   DOI   ScienceOn
12 Channer KS, Roberts JC, Jeyasingham K. Recurrent idiopathic pneumomediastinum. Postgrad Med J 1985;61:1073-5   DOI
13 Munsell WP. Pneumomediastinum: a report of 28 cases and review of the literature. JAMA 1967;202:689-93   DOI
14 Hoover LR, Febinger DL, Tripp HF. Rhinolalia: an underappreciated sign of pneumomediastinum. Ann Thorac Surg 2000;69:615-6   DOI   ScienceOn
15 Halperin AK, Deichmann RE. Spontaneous pneumomediastinum: A report of 10 cases and review of the literature. N C Med J 1985;46:21-3
16 Weissberg D, Weissberg D. Spontaneous mediastinal emphysema. Eur J Cardiothorac Surg 2004;26:885-8   DOI   ScienceOn
17 Weathers LS, Brooks WG, DeClue TJ. Spontaneous pneumomediastinum in a patient with ketoacidosis: a potentially hidden complication. South Med J 1995;88:483-5   DOI   ScienceOn
18 Cyrlak D, Milne E. Pneumomediastinum: A diagnostic problem. CRC Crit Rev Diagn Imaging 1984;23:75-117
19 Kim KI, Lee JW, Lee CH, Park SK. Polypoid endobronchial Hodgkin's isease with pneumomediastinum. Br J Radiol 1999;72:392-4   DOI
20 Langwieler TE, Steffani KD, Bogoevski DP, Mann O, Izbicki JR. Spontaneous pneumomediastinum. Ann Thorac Surg 2004;78:711-3   DOI   ScienceOn
21 Panacek EA, Singer AJ, Sherman BW, Prescott A, Rutherford WF. Spontaneous pneumomediastinum: clinical and natural history. Ann Emerg Med 1992;21:67-72   DOI   ScienceOn
22 Laennec RTH. A treatise on diseases of the chest and on mediate auscultation. 3rd ed. London: Thomas & George Underwood 1829;152-78
23 Macklin MT, Macklin CC. Malignant interstitial emphysema of the lungs and mediastinum as an important occult complication in many respiratory diseases and other conditions: interpretation of clinical literature in light of laboratory experiment. Medicine 1844;23:281-358
24 Lee SK, Im JS, Cho NS. Clinical evaluation of pneumomediastinum in adult. Korean J Thorac Cardiovasc Surg 1999; 32:43-8