Case Reports (Jul 2017)

Spontaneous pneumomediastinum. Case report

  • Sebastian Felipe Sierra Umaña,
  • Andrés Garcés Arias,
  • Andrés Fernando Rodríguez Gutiérrez,
  • Diego Fernando López Donato,
  • Luisa Fernanda Patiño Unibio,
  • Laura Marcela Velásquez Gaviria,
  • Laura Salazar Franco,
  • Sebastián Salinas Mendoza,
  • Luis David Sáenz Pérez,
  • Cristian Alejandro Castillo Rodríguez

DOI
https://doi.org/10.15446/cr.v3n2.60485
Journal volume & issue
Vol. 3, no. 2
pp. 91 – 97

Abstract

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Introduction: Spontaneous pneumomediastinum (SPM) is defined as the presence of air in the mediastinum. It is a rare entity considered benign and self-limiting, which mostly affects young adults. Its diagnosis is confirmed through clinical and radiological studies. Case description: 21-year-old male patient with cough and greenish expectoration for four days, associated with dyspnea, chest pain, fever and bilateral supraclavicular subcutaneous emphysema. Chest X-ray suggested pneumomediastinum, which was confirmed by tomography. The patient was hospitalized for observation and treatment. After a positive evolution, he was discharged on the sixth day. Discussion: SPM is a differential diagnosis in patients with chest pain and dyspnea. Its prevalence is lower than 0.01% and its mortality rate is low. It should be suspected in patients with chest pain and subcutaneous emphysema on physical examination. Between 70 and 90% of the cases can be identified by chest X-ray, while confirmation can be obtained through chest tomography. In most cases it does not require additional studies. Conclusion: SPM is a little known cause of acute chest pain, and rarely considered as a differential diagnosis; it is self-limited and has a good prognosis.

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