Pneumomediastinum: Difference between revisions

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*[[Thoracic Trauma]]
*[[Thoracic Trauma]]
*[[Mediastinitis]]
*[[Mediastinitis]]
*[[Subcutanous emphysema]]


==External Links==
==External Links==

Revision as of 23:50, 13 May 2015

Background

Pneumomediastinum with subcutanous emphysema on CT.
  • Also known as mediastinal emphysema
  • Definition: air present in the mediastinum
    • Usually occurs with sudden increase in intra-alveolar pressure causing alveolar rupture, air dissects into pulmonary interstitium and then into mediastinum, neck, or pericardium
  • Life threatening cause is esophageal rupture
  • If no hemodynamic or airway compromise present, spontaneous pneumomediastinum is not a life threatening condition

Causes

Clinical Features

Differential Diagnosis

Chest pain

Critical

Emergent

Nonemergent

Thoracic Trauma

Diagnosis

Traumatic pneumomediastinum and right sided pneumothorax with first rib fracture.
Pneumomediastinum with Angel wing sign
  • CXR or chest CT
    • AP/PA - Ring around right pulmonary artery, air along L heart border, air in upper chest/neck soft tissue
    • Lateral - air along anterior heart border
  • Rule-out esophageal rupture by hx and exam or with esophagoscopy if indicated

Management

  • Supportive
    • No specific therapy for spontaneous pneumomediastinum
  • Treat underlying cause

Disposition

  • Depends on underlying cause and severity of condition
  • Most patients with spontaneous pneumomediastinum, not caused by trauma or esophageal rupture, can be safely discharged

See Also

External Links

References

  1. Quresi SA, Tilyard A (2008). "Unusual Presentation of Spontaneous Mediastinum: A Case Report". Cases Journal 1:349. doi:10.1186/1757-1626-1-349
  2. Beg MH, Reyazuddin, Ansari MM (1988). "Traumatic tension Pneumomediastinum Mimicking Cardiac Tamponade". Thorax 43:576-677. doi: 10.1136/thx.43.7.576.