Gil-Vargas M, González-Rodríguez LE, León-Aguilar VH

Language: Spanish
References: 14
Page: 317-321
PDF size: 906.91 Kb.

ABSTRACT

Pneumomediastinum is the presence of air in the mediastinal space, originated in bronchi, alveoli or esophageal rupture, which runs through the vascular tissue pods and towards the mediastinal space. Pneumomediastinum is classified as spontaneous or traumatic. Secondary pneumomediastinum is considered an unusual entity in children, with very variable incidence. It is associated with acute asthma airway infections, trauma, vomiting, intense efforts, anxiety with hyperventilation and drug use. This is a case report of a previously healthy, 4 year old female toddler with secondary pneumome-diastinum, without trauma or thoracic procedures or instrumentation in child’s pathophysiology associated with cough, with communityacquired pneumonia. It was confirmed by chest and neck radiographs. The pathology was of short duration and required treatment during a short time in the hospital. According to the chest CT scan performed at admission, air was observed migrating from the perivascular bronchial sheaths to the mediastinum ("Macklin effect").

REFERENCES

1. Bilkis Manuel D., Monteverde Ezequiel. Efecto Macklin en el neumomediastino espontáneo pediátrico. Arch Argent Pediatr 2010;108(2):33-36.

2. Aláez A, Galindo J, Páramo J, et al. Un caso de neumomediastino espontáneo que simula un síndrome de Boerhaave. Rev Chil Cir. 2009;61(1):89-91.

3. Van Der Kleij F, Ziljstra J. Pneumomediastinum and severe subcutaneous emphysema. N Engl J Med 2000;342(18):1333.

4. Kundra M, Yousaf Y, Maqbool S, Mahajan P. Boerhaave Syndrome. Unusual cause of chest pain. Ped Emerg Care 2007;23(7):489-491.

5. Olgun H, Turkilmaz A, Aydin Y, Ceviz N. Spontaneous pneumomediastinum in a child as a rare cause of chest pain. Arch Turk Soc Cardiol. 2009;37(1):51-52.

6. Martín-Menjívar Ernesto, et. Cols. Efecto Macklin como causa de neumomediastino posterior a contusión torácica. Reporte de un caso. TRAUMA. 2007;10(2):58-61.

7. Macklin CC. Transport of air along sheaths of pulmonic blood vessels from alveoli to mediastinum: Clinical implications. Arch Internal Medicine. 1939;64:913-26.

8. Carrillo Esper Raúl, Leal Gaxiola Paul. Pneumomediastino y pneumoperitoneo secundarios a efecto Macklin. Rev Asoc Mex Med Crit y Ter Int. 2008;22(2):111-114.

9. Godoy Laura, Morilla Laura et. Cols. Presentación en la Emergencia de un niño con neumomediastino espontáneo. Pediatr. (Asunción). 2011;38(1):49-52.

10. Cáceres M, Ali SZ, Braud R. Spontaneous pneumomediastinum: a comparative study and review of the literature. Ann Thorac Surg. 2008;86:962-966.

11. Gerazounis M, Athanassiadi K, Kalantzi N, Moustardas M. Spontaneous pneumomediastinum: a rare benign entity. J Thorac Cardiovasc Surg. 2003;126:774-776.

12. Takada K, Matsumoto S, Hiramatsu T. Management of spontaneous pneumomediastinum based on clinical experience of 25 cases. Respir Med. 2008;102:1329-1334.

13. Bilkisa MD, Monteverde E. Efecto Macklin en el neumomediastino espontáneo pediátrico: presentación de casos clínicos. Archargent pediatr. 2010;108(2):33-36.

14. Sakai M, Murayama S, Gibo M et al. Frequent cause of the Macklin effect in spontaneous pneumomediastinum. Demonstration by multidetector row cotomography. J Comput Assist Tomogr. 2006;30:92–94.