Spontaneous pneumomediastinum as a cause of neck pain, dysphagia, and chest pain

Spontaneous pneumomediastinum (SPM) is defined as the presence of interstitial air in the mediastinum without any apparent precipitating factor. We present a case of 23 year old male patient, who has been referred to our outpatient clinic with the complaints of sudden chest pain, dyspnea followed by pneumonia and was diagnosed as SPM. The patient was treated with ampicillin sulbactam (4 gr/day) and methylprednisolon (20 mg/day) for 4 days. and oral intake was stopped during treatment. Post treatment, it was observed that the crepitations were disappeared thoroughly and vesicular sounds were heard by oscultation. The control values of arterial blood gas was as following: pH:7,39 pO2:95 mmHg, pCO2:37 mmHg, SaO2: %97. In the 5th day his oral intake was started and he was discharged.

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Spontaneous pneumomediastinum: ten years of our experience in diagnosis and outcome

Open Medicine ◽

10.2478/s11536-013-0311-1 ◽

2014 ◽

Vol 9 (5) ◽

pp. 642-647

Author(s):

Sanja Hromis ◽

Biljana Zvezdin ◽

Ivan Kopitovic ◽

Senka Milutinov ◽

Violeta Kolarov ◽

...

Keyword(s):

Chest Pain ◽

Tertiary Care ◽

Length Of Hospital Stay ◽

Sudden Onset ◽

Recurrent Event ◽

First Episode ◽

Close Monitoring ◽

Tertiary Care Centre ◽

Benign Condition ◽

Spontaneous Pneumomediastinum

AbstractSpontaneous pneumomediastinum (SPM) is a rare clinical condition that may be mild but also dramatic with sudden onset of chest pain and dyspnea accompanied by swelling and subcutaneous crepitations. The objective of this study was to analyze the clinical presentation and outcome of SPM in a specialized pulmonary tertiary care centre over a 10 years year period. In subsequent followup, we received information related to recurrence episodes of SPM by patients or their GPs physicians. Eighteen patients, 15 (83%) men, mean age 24 years (SD ±7.86) were diagnosed with SPM. Predominant symptoms were chest pain and cough (n=11) then dyspnea (n=9). Asthma was the most common predisposing condition (n=12). Pneumomediastinum was present on chest radiograph in 17 cases (94%), and in one case it was detected only by computed tomography. The mean length of hospital stay was 7 days (SD ±4.4 days). All our patients recovered and there were no complications. Recurrent event occurred in one asthma patient, 2 years after the first episode. Although, SPM is usually a self-limiting and benign condition, close monitoring is necessary. Recurrence is rare, but possible, with no evidence that routine monitoring of those patients is needed.

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Spontaneous pneumomediastinum: is it a rare cause of chest pain?

Thorax ◽

10.1136/thx.38.5.383 ◽

1983 ◽

Vol 38 (5) ◽

pp. 383-385 ◽

Cited By ~ 63

Author(s):

A Yellin ◽

M Gapany-Gapanavicius ◽

Y Lieberman

Keyword(s):

Chest Pain ◽

Spontaneous Pneumomediastinum

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Spontaneous pneumomediastinum – a rare cause of chest pain and dyspnoe in children

Journal of Medical Science ◽

10.20883/medical.e570 ◽

2021 ◽

pp. e570

Author(s):

Marcin Mikoś ◽

Katarzyna Jończyk-Potoczna ◽

Paulina Sobkowiak ◽

Anna Bręborowicz ◽

Edyta Nagła ◽

...

Keyword(s):

Chest Pain ◽

Respiratory Insufficiency ◽

Genetic Material ◽

Severe Pneumonia ◽

Rare Condition ◽

Bronchial Tree ◽

Human Bocavirus ◽

Esophageal Rupture ◽

Benign Condition ◽

Spontaneous Pneumomediastinum

Introduction. Spontaneous pneumomediastinum is a very rare condition in children. Nevertheless it should be considered in the differential diagnosis in patients who present with chest pain and dyspnoe.Aim. The aim of our study was to describe clinical presentation, management and outcomes of the paediatric patients with spontaneous pneumomediastinumMaterial and Methods. This was a retrospective analysis of the charts of all the patients who were admitted to the Department of Pneumonology, Paediatric Allergy and Clinical Immunology in a ten year period from 01.01.2011 till 31.12.2020 in whom spontaneous pneumomediastinum was diagnosed.Results. There were 11 children (7 females) with spontaneous pneumomediastinum. The median age of the children was 11 years (range 3 to 17.5 years). Most of the children presented to the hospital with chest pain, three children complained of the neck swelling and four children developed dyspnoe. Three children with the primary spontaneous pneumomediastinum had a history of physical exercise prior to the onset of symptoms. The secondary spontaneous pneumomediastinum occurred in two children with asthma and 4 children with pneumonia. Genetic material of human Bocavirus was identified in 3 cases. In 81.8% of children pneumomediastinum was accompanied by subcutaneous emphysema and in one case, in a child with severe pneumonia and respiratory insufficiency caused by Bocavirus with pneumorrhachis. In 10 children computed tomography was performed, bronchoscopy in 4 and esophagoscopy in two children. There was no evidence of esophageal rupture or bronchial tree rupture in any of our patients. Three children with pneumonia and pneumomediastinum developed respiratory insufficiency, two of these were treated with mechanical ventilation and one with High Flow Nasal Cannula oxygen therapy. All the children received oxygen. In one child surgical procedure was performed and the drain was inserted into mediastinal space in order to decompress it. Outcome was favourable in all children. Mean time to recovery was 10.6 ± 1.2 days. There was no recurrence of symptoms in any of our patients.Conclusions. Spontaneous pneumomediastinum in most cases is a benign condition, sporadically however it may progress rapidly, leading to respiratory insufficiency and warrant invasive management.

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

Jornal Brasileiro de Pneumologia ◽

10.1590/s1806-37562016000000052 ◽

2017 ◽

Vol 43 (2) ◽

pp. 101-105 ◽

Cited By ~ 4

Author(s):

Patrícia Dionísio ◽

Luís Martins ◽

Susana Moreira ◽

Alda Manique ◽

Rita Macedo ◽

...

Keyword(s):

Chest Pain ◽

Rare Condition ◽

Tobacco Consumption ◽

Sudden Increase ◽

Precipitating Factors ◽

Intense Exercise ◽

Predisposing Factor ◽

X Ray ◽

Spontaneous Pneumomediastinum ◽

Chest X Ray

ABSTRACT 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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Spontaneous pneumomediastinum: A report of two cases at a District General Hospital

Obstetric Medicine ◽

10.1177/1753495x211019231 ◽

2021 ◽

pp. 1753495X2110192

Author(s):

Nathanael Yong ◽

Oladimeji Olowu

Keyword(s):

Chest Pain ◽

Rare Condition ◽

District General Hospital ◽

Valsalva Manoeuvre ◽

Second Stage ◽

Spontaneous Pneumomediastinum ◽

Management Algorithm ◽

Second Stage Of Labour ◽

Management Approaches ◽

Limiting Condition

Spontaneous pneumomediastinum is a rare condition thought to be caused by excessive Valsalva manoeuvre during the second stage of labour. Women with pneumomediastinum typically presents with chest pain or tightness, dyspnoea, and a tearing sensation around the neck. It is commonly diagnosed with a chest radiograph but further imaging may be necessary to exclude more sinister conditions with similar clinical features. We describe two cases of pneumomediastinum and the different management approaches with different multi-disciplinary input. It is often a self-limiting condition. We propose a management algorithm for women suspected to have pneumomediastinum during the intrapartum and postpartum period.

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