Neumomediastino espontáneo por inmersión

Spontaneous pneumomediastinum and subcutaneous emphysema as a complication of asthma in children: case report and literature review

“…As shown by Lee and colleagues, the most common ones are: lower airways infection (43.2%), asthma (21%), oesophageal rupture (5.4%), foreign body aspiration (2.7%), and diabetic ketoacidosis (2.7%), with a cause not being found in about 35.1% of patients (idiopathic SPM) [ Lee et al 2010 ]. In recent literature, some cases have been reported due to repeated scuba diving [ Donoso Fuentes et al 2009 ], spontaneous bronchial rupture [ Maithani et al 2012 ], high-frequency oscillatory ventilation [ Hughes et al 2012 ], influenza A (H1N1) virus infection [ Ozdemir et al 2010 ; Patra et al 2011 ], drug rash with eosinophilia and systemic symptoms (DRESS) syndrome [ Giri et al. 2011 ], hyperventilation due to anxiety states [ Crespo Marcos et al.…”

“…Massive build-up of air can even be life-threatening due to chest compression, resulting in progressive hypoxemia and hypercapnia. Substernal crackles synchronous with heart systole (Hamman’s sign) are common (40–80%) [ Donoso Fuentes et al 2009 ]. Differential diagnoses include pneumomediastinum (though association is common), oesophageal perforation (Boerhaave syndrome if spontaneously developed), pneumothorax, hollow viscus rupture, chest trauma, foreign body aspiration, and acute coronary syndrome and pulmonary thromboembolism, both very rare findings in paediatric patients [ Cicak et al 2009 ; Donoso Fuentes et al 2009 ; Reed et al.…”

“…2013 ]. In clinical practice, diagnosis should be confirmed by chest X-ray, including a lateral view to show extraluminal air [ Donoso Fuentes et al. 2009 ].…”

“…2009 ]. When the diagnosis is uncertain, chest computerized tomography (CT) allows small amounts of air in the mediastinum and tracheal injuries to be detected [ Donoso Fuentes et al 2009 ; Cremaschini et al 2012 ]. If an oesophageal rupture is suspected, an oesophagogram should be obtained [ Crespo Marcos et al 2006 ; Cicak et al 2009 ].…”

“…SPM is usually benign and self-limiting, with only supporting therapy being needed; rest for 1–4 days, analgesia, oxygen, and clinical monitoring [ Crespo Marcos et al 2006 ; Donoso Fuentes et al. 2009 ; Cremaschini et al 2012 ].…”