HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Kalliopi Athanassiadi Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Gerazounis, M. Articles by Moustardas, M. Search for Related Content PubMed PubMed Citation Articles by Gerazounis, M. Articles by Moustardas, M. Related Collections Mediastinum

J Thorac Cardiovasc Surg 2003;126:774-776
© 2003 The American Association for Thoracic Surgery

General thoracic surgery

Spontaneous pneumomediastinum: a rare benign entity

^a Department of Thoracic Surgery, General Hospital of Nikea, Piraeus, Greece

Received for publication July 1, 2002; revisions received August 19, 2002; revisions received September 11, 2002; accepted for publication October 10, 2002.

^* Address for reprints: Kalliopi Athanassiadi, MD, 34A Konstantinoupoleostr., 15562 Holargos, Athens, Greece
kallatha{at}otenet.gr

OBJECTIVE: Spontaneous pneumomediastinum usually occurs in young people without an apparent precipitating factor or disease. Thoracic surgeons are involved in the diagnosis and management of this entity because of the potentially life-threatening conditions that either must be treated as an emergency or excluded, such as esophageal perforation or necrotizing mediastinitis. We present our modest experience in treating spontaneous pneumomediastinum.

MATERIALS: Between 1988 and 1998 we treated 22 cases of spontaneous pneumomediastinum in 18 male patients and 4 female patients, ranging in age between 12 and 32 years. All traumatic cases were excluded. Retrosternal chest pain was the main symptom the patients presented. In only 11 cases was subcutaneous emphysema present. Chest radiography was diagnostic in all our cases. Computed tomographic scan, when performed, confirmed the diagnosis. An esophagogram was essential to exclude an esophageal rupture. Last, a cardiologic examination especially focusing on pericarditis excluded cardiac disease.

RESULTS: Conservative treatment consisted of bed rest, oxygen therapy, and analgesics, which led to rapid resolution of the spontaneous pneumomediastinum. The mean hospital stay ranged between 3 and 10 days. In a follow-up of 3 to 12 years only 1 recurrence was observed.

CONCLUSION: Spontaneous pneumomediastinum is usually an undiagnosed benign entity that responds very well to conservative treatment. It should be considered in the differential diagnosis of chest pain, especially in healthy adolescents and young adults.

This article has been cited by other articles:

				M. Caceres, S. Z. Ali, R. Braud, D. Weiman, and H. E. Garrett Jr Spontaneous Pneumomediastinum: A Comparative Study and Review of the Literature Ann. Thorac. Surg., September 1, 2008; 86(3): 962 - 966. [Abstract] [Full Text] [PDF]

				I. Macia, J. Moya, R. Ramos, R. Morera, I. Escobar, J. Saumench, V. Perna, and F. Rivas Spontaneous pneumomediastinum: 41 cases Eur. J. Cardiothorac. Surg., June 1, 2007; 31(6): 1110 - 1114. [Abstract] [Full Text] [PDF]

				N. Madershahian, M. Meyn, J. T Strauch, and T. Wahlers Spontaneous Cervical Emphysema and Pneumomediastinum in an 18-year-old Woman Asian Cardiovasc Thorac Ann, February 1, 2006; 14(1): e9 - e11. [Abstract] [Full Text] [PDF]

				A. E. Newcomb and C. P. Clarke Spontaneous Pneumomediastinum: A Benign Curiosity or a Significant Problem? Chest, November 1, 2005; 128(5): 3298 - 3302. [Abstract] [Full Text] [PDF]

				E. Mannarino, G. Lupattelli, and G. Schillaci A 32-year-old woman with breast swelling and crepitant rales Can. Med. Assoc. J., November 9, 2004; 171(10): 1172 - 1172. [Full Text] [PDF]

				D. Weissberg and D. Weissberg Spontaneous mediastinal emphysema Eur. J. Cardiothorac. Surg., November 1, 2004; 26(5): 885 - 888. [Abstract] [Full Text] [PDF]

				P. Mihos, K. Potaris, I. Gakidis, E. Mazaris, E. Sarras, and Z. Kontos Sports-related spontaneous pneumomediastinum Ann. Thorac. Surg., September 1, 2004; 78(3): 983 - 986. [Abstract] [Full Text] [PDF]

				G. J. Koullias, D. P. Korkolis, X. J. Wang, and G. L. Hammond Current assessment and management of spontaneous pneumomediastinum: experience in 24 adult patients Eur. J. Cardiothorac. Surg., May 1, 2004; 25(5): 852 - 855. [Abstract] [Full Text] [PDF]