Pneumomediastinum and Pneumopericardium in an 11-Year-Old Rugby Player: A Case Report

Abstract

Objective: Pneumomediastinum and pneumopericardium are rare occurrences in young athletes, but they can result in potentially life-threatening consequences.Background: While involved in a rugby match, an 11-year-old boy received a chest compression by 3 players during a tackle. He continued to play, but 2 hours later, he developed sharp retrosternal chest pain. A chest radiograph and an echocardiograph at the nearest emergency department showed pneumopericardium and pneumomediastinum.Differential Diagnosis: Sternal and rib contusions, rib fractures, heartburn, acute asthma exacerbation, pneumomediastinum, pneumopericardium, pneumothorax, traumatic tracheal rupture, myocardial infarction, and costochondritis (Tietze syndrome).Treatment: Acetaminophen for pain control. Uniqueness: To our knowledge, this is the only case in the international literature of the simultaneous occurrence of pneumomediastinum and pneumopericardium in a child as a consequence of blunt chest trauma during a rugby match.Conclusions: Pneumomediastinum and pneumopericardium may be consequences of rugby blunt chest trauma. Symptoms can appear 1 to 2 hours later, and the conditions may result in serious complications. Immediate admission to the emergency department is required.

Spontaneous pneumomediastinum, pneumopericardium, pneumothorax and subcutaneous emphysema in patients with COVID-19 pneumonia, a case report

“…Pulmonary barotrauma from mechanical ventilation, especially with high positive end-expiratory end pressure (PEEP), is a well-known risk factor for pneumomediastinum and pneumopericardium. High intra-alveolar pressure causes susceptible alveoli to rupture allowing air to dissect along the bronchovascular sheaths towards the mediastinum [6]. Occasionally, pressure accumulation in the mediastinum causes air to escape into the pleural space (pneumothorax) or through weaknesses of the parietal pericardium (pneumopericardium).…”

“…Occasionally, pressure accumulation in the mediastinum causes air to escape into the pleural space (pneumothorax) or through weaknesses of the parietal pericardium (pneumopericardium). Air can also travel towards the thoracic inlet and into the neck soft tissue causing cervico-facial subcutaneous emphysema [6].…”

Dyspnoea and chest pain as the presenting symptoms of pneumomediastinum : two cases and a review of the literature

“…Iatrogenic pneumomediastinum may develop as a result of bronchial or oesophageal rupture during endoscopy, barotrauma during mechanical ventilation, or after tracheostomy. 8 …”

“…In addition to subcutaneous emphysema, physical examination may show a crackling sound synchronous with the heartbeat (Hamman sign), which is pathognomonic for pneumomediastinum. 8 …”

Spontaneous Pneumomediastinum in a Pediatric Patient After a 1600-m Run: Case Report and Literature Review

“…Primary SPM in particular is exceedingly rare and has been described in few case reports. [3][4][5] We report the case of a patient who was found to have SPM after presenting with chest discomfort and shortness of breath after running 1600 m. To our knowledge, this case is the first reported instance of SPM after a moderate-distance run.…”