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

2017 ◽  
Vol 43 (2) ◽  
pp. 101-105 ◽  
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.

scholarly journals Hamman’s syndrome: a case report of spontaneous pneumomediastinum after vaginal delivery

2020 ◽  
Vol 9 (4) ◽  
pp. 1735
Author(s):  
Marco Gentile ◽  
Mariaconcetta Zinna ◽  
Antonio Costanza ◽  
Andrea Remo ◽  
Giuseppe Sala ◽  
...  
Keyword(s):  
Rare Complication ◽  
Rare Condition ◽  
Medical Problem ◽  
Lateral View ◽  
X Ray ◽  
Second Stage Of Labor ◽  
Second Stage ◽  
Spontaneous Pneumomediastinum ◽  
Second Stage Of Labour ◽  
Chest X Ray

Spontaneous pneumediastinum (Hamman’s syndrome) is a rare pathology defined as the presence of free air in the mediastinum with subcutaneous emphysema without trauma or medical problem. It is also a rare complication of labour and delivery and it usually occurs in the second stage of labour. A twenty-six-year-old primigravida presented to our hospital at 39 weeks and 6 days in spontaneous labour. Two hours following the delivery the patient developed neck tightness and chest tenderness with palpation. Chest X-ray and CT scan revealed pneumomediastinum extending into the soft tissue of the neck. A conservative management was performed. Spontaneous pneumomediastinum is a rare condition with a reported incidence of less than 1:44000 and in the setting of pregnancy or labor 1:100000. Regarding pregnancy, the valsalva maneuvers produced in the second stage of labor has been implicated in the development of spontaneous pneumomediastinum. Chest X-ray (posteroanterior and lateral view) is the most important test to confirm the diagnosis. The Hamman’s syndrome has usually a benign course and the management in often conservative. A timely diagnosis of Hamman’s syndrome is necessary for patient safety and correct management, but most cases have a self-limiting course.

scholarly journals Spontaneous Pneumomediastinum in an Adolescent Soccer Player

2021 ◽  
pp. 52-55
Author(s):  
Akinori Kobayakawa ◽  
Hideki Hiraiwa ◽  
Shinya Ishizuka ◽  
Satoshi Yamashita ◽  
Hiroki Oba ◽  
...  
Keyword(s):  
Soccer Player ◽  
Ct Scanning ◽  
Soccer Players ◽  
Alveolar Pressure ◽  
Precipitating Factors ◽  
X Ray ◽  
Clinical Disorder ◽  
Spontaneous Pneumomediastinum ◽  
Chest X Ray ◽  
Male Soccer Player

Spontaneous pneumomediastinum (SPM) is an uncommon and usually benign self-limiting clinical disorder found in young people, often without apparent precipitating factors or diseases. A pressure gradient exists between the peripheral pulmonary alveoli and the hilum, and increased intra-alveolar pressure causes rupture of the terminal alveoli. We present the case of a 15-year-old male soccer player who presented with a complaint of anterior chest pain and dysphagia after stopping the strong ball with his chest. His symptom gradually progressed over hours. We can make the diagnosis of SPM using by chest X-ray and computed tomography (CT) scanning. His symptoms were gradually resolved over the course of approximately one week with no exercise and careful observation. We believe that our case provides very useful information to alert clinicians and coaches regarding this rare disease that may occur in anyone including adolescent soccer players.

Spontaneous Pneumomediastinum: Uncommon Cause of Air Leak in Late Preterm Neonate

2021 ◽  
Vol 35 (2) ◽  
pp. 93-94
Author(s):  
Jyotsna Bhushan ◽  
Shagufta Iqbal ◽  
Abhishek Chopra
Keyword(s):  
Respiratory Distress ◽  
Conservative Management ◽  
Preterm Neonate ◽  
Late Preterm ◽  
Intravenous Fluids ◽  
X Rays ◽  
Blood Gas ◽  
X Ray ◽  
Spontaneous Pneumomediastinum ◽  
Chest X Ray

A clinical case report of spontaneous pneumomediastinum in a late-preterm neonate, chest x-ray showing classical “spinnaker sail sign,” which was managed conservatively and had excellent prognosis on conservative management. Respiratory distress in a preterm neonate is a common clinical finding. Common causes include respiratory distress syndrome, transient tachypnea of the newborn, pneumonia, and pneumothorax. Pneumomediastinum is not very common cause of respiratory distress and more so spontaneous pneumomediastinum. We report here a preterm neonate with spontaneous pneumomediastinum who had excellent clinical recovery with conservative management. A male baby was delivered to G3P1A1 mother at 34 + 6 weeks through caesarean section done due to abruptio placenta. Apgar scores were 8 and 9. Maternal antenatal history was uneventful and there were no risk factors for early onset sepsis. Baby had respiratory distress soon after birth with Silverman score being 2/10. Baby was started on oxygen (O2) by nasal prongs through blender 0.5 l/min, FiO2 25%, and intravenous fluids. Blood gas done was normal. Possibility of transient tachypnea of newborn or mild hyaline membrane disease was kept. Respiratory distress increased at 20 h of life (Silverman score: 5), urgent chest x-ray done revealed “spinnaker sign” suggestive of pneumomediastinum, so baby was shifted to O2 by hood with FiO2 being 70%. Blood gas repeated was normal. Baby was managed conservatively on intravenous fluids and O2 by hood. Baby was gradually weaned off from O2 over next 5 days. As respiratory distress decreased, baby was started on orogastric feed, which baby tolerated well and then was switched to oral feeds. Serial x-rays showed resolution of pneumomediastinum. Baby was discharged on day 7 of life in stable condition on breast feeds and room air.

Suggests More Tests for Chest Pain Diagnosis

PEDIATRICS ◽  
1978 ◽  
Vol 61 (1) ◽  
pp. 143-144
Author(s):  
Michael F. Elmore ◽  
Glen A. Lehman
Keyword(s):  
Chest Pain ◽  
Physical Examination ◽  
Pediatric Patients ◽  
Laboratory Studies ◽  
Psychiatric Interview ◽  
X Ray ◽  
Pain Diagnosis ◽  
Chest X Ray ◽  
Pain Characteristics ◽  
Diagnostic Work

Driscoll et al. (Pediatrics 57:648, May 1976) reported a series of 43 patients with chest pain evaluated by history and physical examination, psychiatric interview, screening laboratory studies, ECG, and chest x-ray film. No organic cause was identified in 45% of patients, and various psychiatric aspects of the pain were discussed. The history obtained from pediatric patients is often suboptimal, and specific pain characteristics and associations cannot be defined. We therefore propose that more vigorous diagnostic work-ups are necessary before chest pain can be classed as "idiopathic."

scholarly journals Spontaneous pneumomediastinum and subcutaneous emphysema in a child with unknown aetiology

2019 ◽  
Vol 12 (2) ◽  
pp. e226805
Author(s):  
Anoopkishore Chidambaram ◽  
Sirisha Donekal
Keyword(s):  
Subcutaneous Emphysema ◽  
Rare Entity ◽  
X Ray ◽  
Spontaneous Pneumomediastinum ◽  
Expert Opinions ◽  
Repeat Chest ◽  
Chest X Ray ◽  
Red Flag ◽  
Surgical Emphysema ◽  
Safety Netting

Spontaneous subcutaneous emphysema and pneumomediastinum in children without any predisposing factors is a rare entity. We present a case of an adolescent boy with spontaneous pneumomediastinum. He is a 14-year-old boy brought to the hospital with an odd feeling in the neck and chest. Initial chest X-ray revealed subcutaneous emphysema and pneumomediastinum. He was further evaluated with CT thorax and abdomen with contrast which revealed extensive pneumomediastinum with associated surgical emphysema in the chest wall and neck. Expert opinions from the cardiothoracic and respiratory teams were obtained. The child was discharged with safety netting and description of red flag signs. Repeat chest X-ray in 2 weeks showed complete resolution of the pneumomediastinum and subcutaneous emphysema. We will briefly discuss about the diagnosis and treatment of spontaneous pneumomediastinum and subcutaneous emphysema.

DOZ047.79: Bronchoscopic treatment of plastic bronchitis in children

2019 ◽  
Vol 32 (Supplement_1) ◽  
Author(s):  
M Y Erdas ◽  
N Valiyev ◽  
K K Cerit ◽  
Y Gokdemir ◽  
G Kiyan
Keyword(s):  
Respiratory Distress ◽  
Rare Condition ◽  
Airway Disease ◽  
Underlying Disease ◽  
Bronchial Tree ◽  
X Rays ◽  
Plastic Bronchitis ◽  
Left Hemithorax ◽  
X Ray ◽  
Chest X Ray

Abstract Purpose Plastic bronchitis or cast bronchitis is a rare condition characterized by the formation of large gelatinous or rigid airway casts. Classification of plastic bronchitis is done by disease association and cast histology. This rare condition can cause airway obstruction and there is no standardized treatment. Here are presented two cases with plastic bronchitis treated by bronchoscopic removal of casts in our clinic. Patients Case 1: A 9-year-old boy presented with wheezing, cough, and respiratory distress. He expectorated the cast spontaneously and the cast was misdiagnosed as germinative membrane of a hydatid cyst at the previous center. Total collapse of the left hemithorax was seen on chest X-ray. Any underlying disease was not detected. The plastic-like solid structure was detected and easily extracted from the bronchial tree. Pathology results of the casts were eosinophilic mucoid casts. The patient experienced three bronchoscopic removals and had no recurrence thereafter for two years. Case 2: A 7-year-old girl presented with persistent cough and respiratory distress. The patient was referred to our center with the diagnosis of foreign body aspiration. Total collapse of the right middle and lower segment and partial collapse of the upper segment were seen on chest X-ray. Previously, she was diagnosed with reactive airway disease. The plastic-like semisolid structure was detected during bronchoscopy its extraction from the bronchial tree was not easy but was possible. Pathology results were eosinophilic mucoid and fibrinotic casts. This patient still needs bronchoscopy for cast removal after 12 bronchoscopic removals but her symptoms and bronchoscopy findings have regressed with time. Conclusion Bronchoscopic extraction of casts provides fast improvement of patients’ symptoms and postoperative chest X-rays, but recurrence of cast formation is common. Nevertheless, it is the mostly chosen therapy in the literature. Further researches in this area are required.

scholarly journals Aurea diagnosis of pneumomediastinum. A case report

2020 ◽  
Vol 14 (3) ◽  
pp. 179-183
Author(s):  
Lucio Brugioni ◽  
Francesca De Niederhausern ◽  
Chiara Gozzi ◽  
Pietro Martella ◽  
Elisa Romagnoli ◽  
...  
Keyword(s):  
Emergency Department ◽  
Case Report ◽  
Chest Pain ◽  
Correct Diagnosis ◽  
Young Male ◽  
Differential Diagnoses ◽  
Diagnostic Process ◽  
Acute Aortic Syndrome ◽  
X Ray ◽  
Chest X Ray

Pericarditis and spontaneous pneumomediastinum are among the pathologies that are in differential diagnoses when a patient describes dorsal irradiated chest pain: if the patient is young, male, and long-limbed, it is necessary to exclude an acute aortic syndrome firstly. We present the case of a young man who arrived at the Emergency Department for chest pain: an echocardiogram performed an immediate diagnosis of pericarditis. However, if the patient had performed a chest X-ray, this would have enabled the observation of pneumomediastinum, allowing a correct diagnosis of pneumomediastinum and treatment. The purpose of this report is to highlight the importance of the diagnostic process.

scholarly journals Pneumomediastinum and pneumopericardium in an adolescent with asthma attacks. Case report

Case reports ◽  
2020 ◽  
Vol 6 (1) ◽  
pp. 63-69
Author(s):  
María Fernanda Ochoa-Ariza ◽  
Jorge Luis Trejos-Caballero ◽  
Cristian Mauricio Parra-Gelves ◽  
Marly Esperanza Camargo-Lozada ◽  
Marlon Adrián Laguado-Nieto
Keyword(s):  
Case Report ◽  
Chest Pain ◽  
Subcutaneous Emphysema ◽  
Respiratory Symptoms ◽  
Laboratory Tests ◽  
Young Patients ◽  
Clinical Suspicion ◽  
X Ray ◽  
Chest X Ray ◽  
The Right

Introduction: Pneumomediastinum is defined as the presence of air in the mediastinal cavity. This is a rare disease caused by surgical procedures, trauma or spontaneous scape of air from the lungs; asthma is a frequently associated factor. It has extensive differential diagnoses due to its symptoms and clinical signs.Case presentation: A 17-year-old female patient presented with respiratory symptoms for 2 days, dyspnea, chest pain radiated to the neck and shoulders, right supraclavicular subcutaneous emphysema, wheezing in both lung fields, tachycardia and tachypnea. On admission, laboratory tests revealed leukocytosis and neutrophilia, and chest X-ray showed subcutaneous emphysema in the right supraclavicular region. Diagnosis of pneumomediastinum was confirmed through a CT scan of the chest. The patient was admitted for treatment with satisfactory evolution.Discussion: Pneumomediastinum occurs mainly in young patients with asthma, and is associated with its exacerbation. This condition can cause other complications such as pneumopericardium, as in this case. The course of the disease is usually benign and has a good prognosis.Conclusion: Because of its presentation, pneumomediastinum requires clinical suspicion to guide the diagnosis and treatment. In this context, imaging is fundamental.

Man in his 50s with chest pain and dyspnoea

Heart ◽  
2018 ◽  
Vol 104 (10) ◽  
pp. 868-868 ◽  
Author(s):  
Yuki Obayashi ◽  
Chisato Izumi ◽  
Yoshihisa Nakagawa
Keyword(s):  
Chest Pain ◽  
Emergency Room ◽  
Prosthetic Valve ◽  
Cardiopulmonary Arrest ◽  
Supplementary File ◽  
List Type ◽  
Main Trunk ◽  
X Ray ◽  
Doppler Image ◽  
Chest X Ray

Clinical introductionA man in his 50s with sudden-onset chest pain and dyspnoea was transferred to the emergency room. He had a history of aortic valve replacement due to aortic regurgitation with a mechanical valve 6 years previously. Heart rate was 90 bpm, and blood pressure was too low to measure. In the emergency room, he presented with severe dyspnoea and a chest X-ray showed severe lung congestion (figure 1A). ECG showed complete left bundle branch block. His respiratory status rapidly worsened, and he went into cardiopulmonary arrest. After cardiopulmonary resuscitation, transthoracic echocardiography was performed (figure 1B, online supplementary video 1).Supplementary file 1Figure 1(A) Chest X-ray. (B) Colour Doppler image from apical five-chamber view.QuestionWhat is the most likely cause of the patient’s cardiopulmonary arrest?Myocardial infarction in left main trunkAortic dissectionProsthetic valve thrombosisProsthetic valve embolisationPulmonary embolism

scholarly journals A patient with fever, chest pain and a rapidly changing chest X-ray

2010 ◽  
Vol 3 (4) ◽  
pp. 525-526
Author(s):  
Bas de Groot ◽  
Daan Brand ◽  
Tessel N. E. Vossenberg ◽  
Andrea Warnemunde
Keyword(s):  
Chest Pain ◽  
X Ray ◽  
Chest X Ray
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