Spontaneous pneumomediastinum: report of two cases

Authors

  • Luciana Barbosa Department of Pediatrics, Centro Hospitalar Vila Nova de Gaia/Espinho
  • Joana Cardoso Department of Pediatrics, Centro Hospitalar Vila Nova de Gaia/Espinho
  • Joana Rodrigues Department of Pediatrics, Centro Hospitalar Vila Nova de Gaia/Espinho
  • Maria José Dinis Department of Pediatrics, Centro Hospitalar Vila Nova de Gaia/Espinho
  • Isabel Carvalho Department of Pediatrics, Centro Hospitalar Vila Nova de Gaia/Espinho

DOI:

https://doi.org/10.25753/BirthGrowthMJ.v26.i3.13493

Keywords:

Asthma, children, pneumonia, spontaneous pneumomediastinum, subcutaneous emphysema

Abstract

Introduction: Spontaneous pneumomediastinum is a rare clinical condition in childhood that occurs in most cases with exacerbations of asthma. The most common symptoms are chest pain and dyspnea. Diagnosis is usually made by chest radiography. Conservative treatment is preferred with a favorable prognosis.

Case reports: The first case, a 14-year-old boy with spontaneous pneumomediastinum and subcutaneous emphysema diagnosis, without triggering factor, despite history of asthma. The second one, a 19-month-old boy who developed, as a complication of pneumonia, a spontaneous thoraco-cervical pneumomediastinum and pneumothorax. The evolution was favorable, in the first case only with symptomatic treatment and in the second, progressive respiratory improvement was observed, after a chest drain insertion.

Discussion/Conclusions: These cases are examples of spontaneous pneumomediastinum that highlights the rarity of this disease in this age group.

References

Hamman L. Spontaneous mediastinal emphysema. Bull Johns Hopkins Hosp 1939; 64: 1-21.

Macklin, CC. Transport of air along sheaths of pulmonic blood vessels from alveoli to mediastinum: clinical implications. Arch Intern Med 1939; 64: 913-26.

Dekel B, Paret G, Szeinberg A, Vardi A, Barzilay Z. Spontaneous pneumomediastinum in children: clinical and natural history. Eur J Pediatr 1996; 153: 695−7.

Panacek EA, Singer AJ, Sherman BW, Prescott A, Rutherford WF. Spontaneous pneumomediastinum: clinical and natural history. Am Emerg Med 1992; 21: 1222−7.

Abolnik I, Lossos IS, Breuer R. Spontaneous pneumomediastinum: a report of 25 cases. Chest 1991; 100: 93−5.

Chalumeau M, Le Clainche L, Sayeg N, Sannier N. Michel JL, Marianowski R., et al. Spontaneous pneumomediastinum in children. Pediatr Pulmonol 2001; 31: 67−75.

Stack AM, Caputo GL. Pneumomediastinum in childhood asthma. Pediatr Emerg Care 1996; 12: 98-101.

Roe PF, Kulkarni BN. Pneumomediastinum in children with cough. Br J Dis Chest 1967; 61: 147-50.

Yellin, A, Gapany-Gapanavicius, M, Lieberman, Y. Spontaneous pneumomediastinum: is it a rare cause of chest pain? Thorax 1983; 38: 383-85.

Chu CP, Chen PP. Tracheobronchial injury secondary to blunt chest trauma: diagnosis and management. Anaesth Intensive Care 2002; 30: 145-52.

Al-Mufarrej F, Badar J, Gharagozloo F, Tempesta B, Strother E, Margolis M. Spontaneous pneumomediastinum: diagnostic and therapeutic interventions. J Cardiothorac Surg. 2008;3:59.

Macia I, Moya J, Ramos R, et al. Spontaneous pneumomediastinum: 41 cases. Eur J Cardiothorac Surg 2007; 31: 1110-14.

Herlan DB, Landreneau RJ, Ferson PF. Massive spontaneous subcutaneous emphysema. Acute management with infraclavicular ‘‘blow holes’’. Chest 1992; 102: 503-5.

How to Cite

Barbosa, L., Cardoso, J., Rodrigues, J., Dinis, M. J., & Carvalho, I. (2017). Spontaneous pneumomediastinum: report of two cases. NASCER E CRESCER - BIRTH AND GROWTH MEDICAL JOURNAL, 26(3), 178–181. https://doi.org/10.25753/BirthGrowthMJ.v26.i3.13493

Issue

Section

Case Reports

Most read articles by the same author(s)