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ISSN 1684-1824 (Electronic)

2022, Number 1

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Rev Méd Electrón 2022; 44 (1)

Spontaneouspneumomediastinum. Case report

Vidaillet-Rodríguez O, Carrasco-Blanco Y, García-Marrero Y, Vidaillet-Carrasco A

Language: Spanish
References: 40
Page: 247-258
PDF size: 2831.41 Kb.


ABSTRACT

The spontaneous pneumomediastinum is characterized by the air presence in the mediastinum. It is a generally benign disease which evolves in a satisfactory way between 2 and 15 days, that is not associated to any directly known cause. It is infrequent in the old age. It mainly presents with chest pain, dyspnea and subcutaneous emphysema. Diagnosis realizes on the base of clinical characteristics, thorax radiography and thorax axial computed tomography, being the last one also important to establish the differential diagnosis with Boerhaave syndrome in an opportune way. The case presented is the case of a male patient aged 67 years, who smokes and has antecedents of chronic obstructive pulmonary disease. He assisted to the consultation due to thoracic pain, dyspnea and subcutaneous emphysema after an episode of intense cough. Posteroanterior and lateral thorax radiography were done, finding air presence in the mediastinum; other acute diseases were discarded and the diagnosis of pneumomediastinum was corroborated through thorax computed tomography scan. He was treated with oxygen, bronchodilators, steroids and antibiotics therapy, obtaining an evident improvement. The literature reports that the presence of these characteristics in old-aged patients is not common and that it must be suspected in those presenting an aggravation of the chronic obstructive pulmonary disease, mainly after a cough episode.


REFERENCES

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  2. Chidambaram A, Donekal S. Spontaneous pneumomediastinum and subcutaneous emphysema in a child with unknown aetiology. BMJ Case Rep.2019;12(2).Citado en PubMed; PMID: 30765441.

  3. Spotts PH. Spontaneous pneumomediastinum: Case presentation to a college student health clinic. J Am CollHealth.2017;65(8):575-8. Citado en PubMed; PMID: 28708045.

  4. Yurtseven A, Saz EU. Red flag; wheezing with neck pain may be a clue to the early diagnosis of spontaneous pneumomediastinum. Tuberk Toraks. 2017;65(2):146-9. Citado en PubMed; PMID: 28990894.

  5. López-Hernández JC, Bedolla-Barajas M. Neumomediastino y enfisema subcutáneo espontáneos postparto: informe de un caso. Ginecol Obstet Méx [Internet]. 2015 Feb [citado 16/02/2015];83(2):116-9. Disponible en: Disponible en: https://www.medigraphic.com/pdfs/ginobsmex/gom-2015/gom152g.pdf

  6. Jaensch S, Hwang S, Kuo TS. Spontaneous Pneumomediastinum and Subcutaneous Emphysema following Cocaine Inhalation and Ecstasy Ingestion. Case Rep Otolaryngol. 2019;2019:6972731. Citado en PubMed; PMID: 30918737.

  7. Londoño Duarte MP, Ávila Arenas LM. Neumomediastino espontáneo: revisión de tema. Universidad Médica [Internet]. 2017 [citado 16/05/2019];58(4). Disponible en: Disponible en: https://revistas.javeriana.edu.co/index.php/vnimedica/article/view/20341

  8. Bedolla-Pulido TR, Bedolla-Barajas M. Spontaneous pneumomediastinum and subcutaneous emphysema associated with bronchospasm in a woman with no history of asthma. Rev Alerg Méx [Internet]. 2017 Jul [citado 16/05/2019];64(3):386-9. Disponible en: Disponible en: http://search.ebscohost.com/login.aspx?direct=true&db=lth&AN=125899432&lang=es&site=ehost-live

  9. Campbell S, Vargas AS, Gómez JM, et al. Síndrome de Hamman. Acta Med Colomb [Internet]. 2016 Jul [citado 16/02/2019];41(3):206-10. Disponible en: http://www.scielo.org.co/scielo.php?script=sci_arttext&pid=S0120-24482016000300206

  10. Oliveira Duarte N, Hino Verdelho C, Mendes Queiroz R. Presence of gas in an unusual place: spontaneous pneumomediastinum (Hamman’s syndrome). J Bras Pneumol [Internet].2018 [citado 16/05/2019];44(4). Disponible en: Disponible en: https://www.scielo.br/j/jbpneu/a/yRmV56qz7x6NmVRP8M7ZJcn/?lang=en

  11. Dionísio P, Martins L, Moreira S, et al. Spontaneous pneumomediastinum: experience in 18 patients during the last 12 years. J Bras Pneumol. 2017;43(2):101-5. Citado en PubMed; PMID: 28538776.

  12. Heckman AJ, Mohseni M, Villanueva A, et al. Concurrent Spontaneous Pneumomediastinum and Pneumorrhachis. J Emerg Med. 2018;54(6):e117-20. Citado en PubMed ;PMID: 29685465.

  13. López L, Ramírez Bueno A, Kubarsepp A. Anisocoria Associated with Spontaneous Pneumomediastinum. Arch Bronconeumol [Internet]. 2018 Aug [citado 16/02/2019];54(8):437-9. Disponible en: Disponible en: https://www.archbronconeumol.org/es-anisocoria-associated-with-spontaneous-pneumomediastinum-articulo-S1579212918301812

  14. Chan CWS, Chung HY, Lau CS, et al. Spontaneous pneumomediastinum in a dermatomyositis patient with anti-melanoma differentiation-associated gene-5 antibody and interstitial lung disease despite an initial response to immunosuppressant. Int J Rheum Dis. 2019;22(3):521-4. Citado en PubMed; PMID: 28580698.

  15. Donoso Fuentes A, Cruces P, Bertrán Salinas K. Immersion-induced Spontaneous pneumomediastinum. An Pediatr (Barc). 2009 Jan;70(1):95-7. Citado en PubMed; PMID: 19174131.

  16. Olaciregu iEchenique I, Plazaola Cortázar A, Uriz Monaut JJ, et al. Subcutaneous emphysema and pneumomediastinum after dental extraction. An Pediatr (Barc). 2014;80(3):195-6. Citado en PubMed; PMID: 24103247.

  17. Polat G, Ogul H, Ergun F, et al. Unusual complication of a lung hydatid cyst: Pneumomediastinum, hydropneumothorax, and massive soft tissue emphysema. Cir Esp. 2017;95(10):610. Citado en PubMed; PMID: 28168956.

  18. Song IH, Lee SY, Lee SJ, et al. Diagnosis and treatment of spontaneous pneumomediastinum: experience at a single institution for 10 years. Gen Thorac Cardiovasc Surg. 2017 May;65(5):280-4. Citado en PubMed; PMID: 28283793.

  19. Ødegaard KJ, Haavardsholm E, Husby A. Spontaneous pneumomediastinum. Tidsskr Nor Laegeforen. 2018;138(11). Citado en PubMed; PMID: 29947201.

  20. Barquero-Romero J, Redondo-Moralo MJ. Spontaneous pneumomediastinum and subcutaenous emphysema: an uncommon complication of lung cancer. Arch Bronconeumol. 2009 Jun;45(6):310-1. Citado en PubMed; PMID: 19376626.

  21. Reyes Hernández D, García Reyes C. Neumomediastino espontáneo recidivante. Rev Cubana Med Mil [Internet]. 2017 Sep [citado 16/02/2019];46(3):289-95. Disponible en: Disponible en: http://scieloprueba.sld.cu/scielo.php?script=sci_arttext&pid=S0138-65572017000300009&lng=es

  22. Chidambaram A, Donekal S. Spontaneous pneumomediastinum and subcutaneous emphysema in a child with unknown aetiology. BMJ Case Rep.2019;12(2).Citado en PubMed; PMID: 30765441.

  23. Spotts PH. Spontaneous pneumomediastinum: Case presentation to a college student health clinic. J Am CollHealth.2017;65(8):575-8. Citado en PubMed; PMID: 28708045.

  24. Yurtseven A, Saz EU. Red flag; wheezing with neck pain may be a clue to the early diagnosis of spontaneous pneumomediastinum. Tuberk Toraks. 2017;65(2):146-9. Citado en PubMed; PMID: 28990894.

  25. López-Hernández JC, Bedolla-Barajas M. Neumomediastino y enfisema subcutáneo espontáneos postparto: informe de un caso. Ginecol Obstet Méx [Internet]. 2015 Feb [citado 16/02/2015];83(2):116-9. Disponible en: Disponible en: https://www.medigraphic.com/pdfs/ginobsmex/gom-2015/gom152g.pdf

  26. Jaensch S, Hwang S, Kuo TS. Spontaneous Pneumomediastinum and Subcutaneous Emphysema following Cocaine Inhalation and Ecstasy Ingestion. Case Rep Otolaryngol. 2019;2019:6972731. Citado en PubMed; PMID: 30918737.

  27. Londoño Duarte MP, Ávila Arenas LM. Neumomediastino espontáneo: revisión de tema. Universidad Médica [Internet]. 2017 [citado 16/05/2019];58(4). Disponible en: Disponible en: https://revistas.javeriana.edu.co/index.php/vnimedica/article/view/20341

  28. Bedolla-Pulido TR, Bedolla-Barajas M. Spontaneous pneumomediastinum and subcutaneous emphysema associated with bronchospasm in a woman with no history of asthma. Rev Alerg Méx [Internet]. 2017 Jul [citado 16/05/2019];64(3):386-9. Disponible en: Disponible en: http://search.ebscohost.com/login.aspx?direct=true&db=lth&AN=125899432&lang=es&site=ehost-live

  29. Campbell S, Vargas AS, Gómez JM, et al. Síndrome de Hamman. Acta Med Colomb [Internet]. 2016 Jul [citado 16/02/2019];41(3):206-10. Disponible en: http://www.scielo.org.co/scielo.php?script=sci_arttext&pid=S0120-24482016000300206

  30. Oliveira Duarte N, Hino Verdelho C, Mendes Queiroz R. Presence of gas in an unusual place: spontaneous pneumomediastinum (Hamman’s syndrome). J Bras Pneumol [Internet].2018 [citado 16/05/2019];44(4). Disponible en: Disponible en: https://www.scielo.br/j/jbpneu/a/yRmV56qz7x6NmVRP8M7ZJcn/?lang=en

  31. Dionísio P, Martins L, Moreira S, et al. Spontaneous pneumomediastinum: experience in 18 patients during the last 12 years. J Bras Pneumol. 2017;43(2):101-5. Citado en PubMed; PMID: 28538776.

  32. Heckman AJ, Mohseni M, Villanueva A, et al. Concurrent Spontaneous Pneumomediastinum and Pneumorrhachis. J Emerg Med. 2018;54(6):e117-20. Citado en PubMed ;PMID: 29685465.

  33. López L, Ramírez Bueno A, Kubarsepp A. Anisocoria Associated with Spontaneous Pneumomediastinum. Arch Bronconeumol [Internet]. 2018 Aug [citado 16/02/2019];54(8):437-9. Disponible en: Disponible en: https://www.archbronconeumol.org/es-anisocoria-associated-with-spontaneous-pneumomediastinum-articulo-S1579212918301812

  34. Chan CWS, Chung HY, Lau CS, et al. Spontaneous pneumomediastinum in a dermatomyositis patient with anti-melanoma differentiation-associated gene-5 antibody and interstitial lung disease despite an initial response to immunosuppressant. Int J Rheum Dis. 2019;22(3):521-4. Citado en PubMed; PMID: 28580698.

  35. Donoso Fuentes A, Cruces P, Bertrán Salinas K. Immersion-induced Spontaneous pneumomediastinum. An Pediatr (Barc). 2009 Jan;70(1):95-7. Citado en PubMed; PMID: 19174131.

  36. Olaciregu iEchenique I, Plazaola Cortázar A, Uriz Monaut JJ, et al. Subcutaneous emphysema and pneumomediastinum after dental extraction. An Pediatr (Barc). 2014;80(3):195-6. Citado en PubMed; PMID: 24103247.

  37. Polat G, Ogul H, Ergun F, et al. Unusual complication of a lung hydatid cyst: Pneumomediastinum, hydropneumothorax, and massive soft tissue emphysema. Cir Esp. 2017;95(10):610. Citado en PubMed; PMID: 28168956.

  38. Song IH, Lee SY, Lee SJ, et al. Diagnosis and treatment of spontaneous pneumomediastinum: experience at a single institution for 10 years. Gen Thorac Cardiovasc Surg. 2017 May;65(5):280-4. Citado en PubMed; PMID: 28283793.

  39. Ødegaard KJ, Haavardsholm E, Husby A. Spontaneous pneumomediastinum. Tidsskr Nor Laegeforen. 2018;138(11). Citado en PubMed; PMID: 29947201.

  40. Barquero-Romero J, Redondo-Moralo MJ. Spontaneous pneumomediastinum and subcutaenous emphysema: an uncommon complication of lung cancer. Arch Bronconeumol. 2009 Jun;45(6):310-1. Citado en PubMed; PMID: 19376626.




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