Pneumorrhachis: an under-recognized entity correlates with severity of spontaneous pneumomediastinum

Liu, Yuwei; Kao, Chieh-Ni; Wang, Yiming

doi:10.21037/jtd.2018.01.65

Cited by 7 publications

(5 citation statements)

References 7 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Less commonly, epidural air may be identified on advanced imaging in the setting of spontaneous pneumomediastinum with an incidence of 5.9 to 9.5% in patients with pneumomediastinum 7,24 . Severity of pneumomediastinum has been shown to be a positive predictor for the likelihood of pneumorrhachis 25 .…”

Section: Discussionmentioning

confidence: 99%

Spontaneous Pneumorrhachis Secondary to Rhinovirus-Associated Emesis with Demonstrated Pathophysiology

Willenbring,

Stark,

Tallarico

2024

JBJS Case Connector

View full text Add to dashboard Cite

Case: This case of a 14-year-old boy presented with repetitive coughing secondary to a rhinovirus infection. In addition to pneumomediastinum, imaging demonstrated asymptomatic, yet significant holocord pneumorrhachis. Conclusion: Ectopic gas within the spinal canal, also referred to as pneumorrhachis or “epidural gas,” may be traumatic, iatrogenic, or less commonly, spontaneous. It is typically an incidental and asymptomatic finding in the setting of pneumomediastinum. Proposed pathophysiology includes air tracking through the intercostal fascial planes posteriorly through the neuroforamina, which offer a theoretical point of entry. Our case clearly demonstrates air along the entirety of the fascial planes confirming the proposed pathophysiology.

show abstract

Section: Discussionmentioning

confidence: 99%

Spontaneous Pneumorrhachis Secondary to Rhinovirus-Associated Emesis with Demonstrated Pathophysiology

Willenbring,

Stark,

Tallarico

2024

JBJS Case Connector

View full text Add to dashboard Cite

show abstract

“…Given imaging technology improvements and the increased use of chest CT scanning for SMP cases, it is likely that PR recognition will rise, specifically when SPM is severe and extensive. 9 Pathologic Discussion PR describes the clinical finding of air within the spinal canal, and it rarely occurs in patients with SPM. 10 The association between PR and SPM is not fully understood, especially when accompanied by asthma exacerbation.…”

Section: Radiologic Discussionmentioning

confidence: 99%

A 17-Year-Old Male Subject With Chest Pain, Worsening Dyspnea, and a Rare Complication

Angi

Papa

Pillo

et al. 2020

Chest

View full text Add to dashboard Cite

Clinical EvaluationA 17-year-old male subject with allergic asthma since childhood was transferred from a local hospital to our Department of Pediatrics with reports of chest pain preceded by 3 days of a dry cough and worsening dyspnea. In the last year, he had been controlling his asthma symptoms exclusively with salbutamol, several times a month. The patient had smoked marijuana and tobacco on the previous morning of admission. He denied neurologic complaint, air travel, trauma, or vomiting. On physical examination, the patient was nontoxic appearing but was short of breath and unable to speak in full sentences. He was afebrile with an initial heart rate of 134 beats/min, a respiratory rate of 35 breaths/min, and room air pulse oximetry of 90%. Blood analysis revealed no significant changes, except for a neutrophil count of 14.62 Â 10

show abstract

“…2 In certain reported cases, air leaks into the pericardial space and spinal canal causing pneumopericardium and pneumorrhachis respectively. [3][4][5] The aim of this study was to evaluate the clinical course and outcome of the SPM patients.…”

Section: Introductionmentioning

confidence: 99%

“…The pathophysiology of SPM is based on the Macklin effect, in which the increase in intra‐thoracic pressure resulted in alveolar rupture, followed by air trapping and dissection through the broncho‐vascular sheath into the mediastinal space 2 . In certain reported cases, air leaks into the pericardial space and spinal canal causing pneumo‐pericardium and pneumorrhachis respectively 3–5 …”

Section: Introductionmentioning

confidence: 99%

Spontaneous pneumo‐mediastinum ‐ A benign rarity?

Wong

Leung

et al. 2022

Surgical Practice

View full text Add to dashboard Cite

Background: Spontaneous pneumo-mediastinum (SPM) is defined as the spontaneous occurrence of free gas in the mediastinum. Although SPM is rare, this is a unique differential cause for pneumo-mediastinum. It bears a benign clinical course with good clinical outcome, unlike others potentially life threatening causes of pneumomediastinum, such as oesophageal perforation and necrotizing mediastinitis. Methods and Results:A retrospective study about SPM was conducted in the Department of Surgery, Tuen Mun Hospital, HKSAR. SPM cases were retrieved through hospital's electronic records from 7/2000 to 6/2020. Patients' demographic data, clinical presentation, management and outcomes were reviewed. One hundred five SPM patients were retrieved with mean age 21.3 (0-68). More than 85% (91 cases) of them were younger age group (younger than the age of 30). Eightyseven cases (82.9%) were male while 18 cases (17.1%) were female. The top 3 presentation symptoms were: chest pain (69 cases, 65.7%), neck pain (43 cases, 41%) and sore throat (42 cases, 40%). Physical examination revealed surgical emphysema in 63 patients (60%). 61 (58.1%) patients enjoyed good past health and without any potential predisposing factors. Common precipitating factors included: vigorous cough (28 cases, 26.7%), vigorous exercise (16 cases, 15.2%), sneezing (15 cases, 14.3%) and vomiting/retching (14 cases, 13.3%).CXR showed pneumo-mediastinum in 98 cases (93.3%). Additional investigations, such as CT neck/thorax/abdomen with contrast (63 cases, 60%) and oesophagogastro-duodenoscopy (OGD) (29 cases, 27.6%), were performed to rule out other differential diagnosis in suspicious cases.All the SPM patients were treated conservatively (e.g. bed rest, analgesics, antibiotics, oxygen supplement). None of them required operative treatment with recurrence rate 0%. Average length of hospital stay was 4.1 days (1-35 days). Two out of 105 cases (1.9%) resulted in hospital mortality due to other underlying medical illnesses. Conclusion:SPM is an uncommon disease, mainly affecting the younger age group.Although SPM carries a benign and good clinical outcome, it is essential to exclude other potential life threatening conditions with similar presentations.

show abstract

Pneumorrhachis: an under-recognized entity correlates with severity of spontaneous pneumomediastinum

Cited by 7 publications

References 7 publications

Spontaneous Pneumorrhachis Secondary to Rhinovirus-Associated Emesis with Demonstrated Pathophysiology

Spontaneous Pneumorrhachis Secondary to Rhinovirus-Associated Emesis with Demonstrated Pathophysiology

A 17-Year-Old Male Subject With Chest Pain, Worsening Dyspnea, and a Rare Complication

Spontaneous pneumo‐mediastinum ‐ A benign rarity?

Contact Info

Product

Resources

About