Management of spontaneous pneumomediastinum in children

Fitzwater, John; Silva, Naomi N.; Knight, Colin G.; Malvezzi, Leopoldo; Ramos, Carlos G.; Burnweit, Cathy

doi:10.1016/j.jpedsurg.2015.03.024

Cited by 39 publications

(59 citation statements)

References 16 publications

(42 reference statements)

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“…In terms of diagnosis, plain chest and neck radiographs, both lateral and anteroposterior views should always be obtained; otherwise up to 50% of cases of pneumomediastinum detected on lateral views would be missed 4. In this case, our CT scan did not alter the management, and one study found that imaging studies beyond the initial chest radiograph (including CT) did not lead to a change in treatment in their 81 paediatric patients with spontaneous pneumomediastinum 5. On reflection, there may be an argument to only consider CT scanning if the patient shows any signs of deterioration, or if there is any uncertainty with respect to a diagnosis.…”

Section: Discussionmentioning

confidence: 94%

Spontaneous pneumomediastinum

Ojha¹,

Gaskin

2018

BMJ Case Reports

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Spontaneous pneumomediastinum is the presence of free air within the mediastinum that is not associated with trauma. It is a rare, self-limiting condition that can cause widespread subcutaneous surgical emphysema. We present the case of a 12-year-old boy who presented with widespread spontaneous surgical emphysema and pneumomediastinum, with no history of trauma or respiratory tract disease. We discuss our assessment of him and management with our multidisciplinary team (MDT), and whether radiological investigations including CT are helpful in such cases. In conclusion, we hypothesised that the child's coughing was the most likely cause of the tracheal rupture leading to the spontaneous surgical emphysema. Spontaneous pneumomediastinum in the paediatric patient is extremely rare. This case highlights how spontaneous pneumomediastinum can be successfully managed conservatively, and how MDT input can be helpful in guiding management in such unusual cases.

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Section: Discussionmentioning

confidence: 94%

Spontaneous pneumomediastinum

Ojha¹,

Gaskin

2018

BMJ Case Reports

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“…There is no specifically treatment of SPM either on adults or children [10][11][12][13]. After diagnostic studies, hospitalization is necessary, oxygen support, bed rest, pain control and/or antibiotic administration is essential.…”

Section: Discussionmentioning

confidence: 99%

Diagnosis and treatment of spontaneous pneumomediastinum is not complicated

Unaldi¹,

Özer²,

Çardak³

et al. 2017

Curr Thorac Surg

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“…La incidencia del síndrome de Hamman ha sido reportada en una de cada 44.000 visitas al servicio de urgencias [11,12], con una relación hombre mujer 8:1 que incluso puede llegar hasta 14:3 [7,12,13]. Para la población pediátrica se muestra una incidencia similar cercana a un caso por cada 30.000 ingresos al servicio de urgencias, con una edad promedio de presentación 17,5 a 25 años, reportada en el estudio realizado por Sung Hoon Kim y colaboradores, en la ciudad de Changwon, entre marzo del 2005 y junio del 2013 [14,15,16]. El curso clínico es habitualmente benigno y autolimitado; pero existen casos con evolución más agresiva y tórpida, secundarios al desarrollo de complicaciones graves como neumomediastino a tensión y neumotórax a tensión concomitante [5].…”

Section: Discussionunclassified

Neumomediastino espontáneo: revisión de tema

Duarte

Arenas

2017

UNIV.MED.

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a RESUMENEl neumomediastino espontáneo se define como la presencia de aire en el mediastino sin que tenga relación con patología traumática, procedimientos quirúrgicos o ventilación mecánica. Se considera una patología benigna y de rara presentación con una sintomatología que puede orientar a otros diagnósticos relacionados con patologías cardiovasculares, digestivas o respiratorias. Con una baja incidencia, la literatura reporta la presencia de un caso por cada 14.000 consultas al servicio de urgencias. Es más frecuente en adultos jóvenes, de sexo masculino, que manifiestan dolor torácico y disnea con otros hallazgos físicos relacionados que hacen sospechar el diagnóstico como la evidencia de enfisema subcutáneo. El artículo presenta una revisión de tema sobre neumomediastino espontáneo, patología poco frecuente, pero de importancia clínica en el diagnóstico diferencial del dolor torácico. Palabras clave neumomediastino espontáneo; mediastino.ABSTRACT Spontaneous pneumomediastinum is defined as the presence of air in the mediastinum that's not directly related to a traumatic pathology, surgical procedures or mechanical ventilation. It is considered a benign pathology which rarely occurs with symptoms that can lead to other diagnosis related to cardiovascular, gastrointestinal or respiratory pathologies. It also has a low incidence according to literature, with reports of only one case for every 14,000 patients that visit emergency care services, having a higher incidence on young male adults that manifest thoracic pain and dyspnea, with additional related physical findings similar to a subcutaneous emphysema. This is a revision concerning spontaneous pneumomediastinum, a low incidence pathology with a clinical importance in the differential diagnosis of thoracic pain.

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Management of spontaneous pneumomediastinum in children

Cited by 39 publications

References 16 publications

Spontaneous pneumomediastinum

Spontaneous pneumomediastinum

Diagnosis and treatment of spontaneous pneumomediastinum is not complicated

Neumomediastino espontáneo: revisión de tema

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