Spontaneous pneumomediastinum: Experience in 13 patients

Migaou, A.; Fahem, N.; Ahmed, Ben Saad; Joobeur, S.; Saoussen, Cheikh mhammed; Rouatbi, N.

doi:10.1016/j.rmcr.2019.100946

Cited by 5 publications

(4 citation statements)

References 7 publications

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“…With these caveats these data demonstrate an incidence of PTM in COVID-19 of 0.64% per inpatient admission and 3.0% per COVID-19 inpatients undergoing thoracic CT. This incidence is similar to rates reported by two other studies of PTM in hospitalised COVID-19 populations from Brazil and Romania, of 0.51% and 0.67% respectively [ 13 , 14 ]. The incidence of “spontaneous” PTM in COVID-19 in this cohort i.e.…”

Section: Discussionsupporting

confidence: 90%

“…It is somewhat younger than the mean age of general COVID-19 inpatients in the UK, according to the largest epidemiological study (70.4 years) [ 20 ]. There could be pathophysiological reasons why COVID-19 inpatients who develop PTM are younger than the hospital population average (we note that background rates of non-COVID-19 PTM typically occur in younger adults) [ 1 , 14 – 15 ]. It could reflect bias towards more frequent imaging in younger patients who are usually eligible for all treatments, with an artificial reduction in the identification of PTM in older patient groups.…”

Section: Discussionmentioning

confidence: 99%

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Pneumomediastinum in COVID-19: a phenotype of severe COVID-19 pneumonitis? The results of the UK POETIC survey

et al. 2022

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BackgroundThere is an emerging understanding that coronavirus disease 2019 (COVID-19) is associated with increased incidence of pneumomediastinum. We aimed to determine its incidence among patients hospitalised with COVID-19 in the United Kingdom and describe factors associated with outcome.MethodsA structured survey of pneumomediastinum and its incidence was conducted from September 2020 to February 2021. United Kingdom-wide participation was solicited via respiratory research networks. Identified patients had SARS-CoV-2 infection and radiologically proven pneumomediastinum. The primary outcomes were to determine incidence of pneumomediastinum in COVID-19 and to investigate risk factors associated with patient mortality.Results377 cases of pneumomediastinum in COVID-19 were identified from 58 484 inpatients with COVID-19 at 53 hospitals during the study period, giving an incidence of 0.64%. Overall 120-day mortality in COVID-19 pneumomediastinum was 195/377 (51.7%). Pneumomediastinum in COVID-19 was associated with high rates of mechanical ventilation. 172/377 patients (45.6%) were mechanically ventilated at the point of diagnosis. Mechanical ventilation was the most important predictor of mortality in COVID-19 pneumomediastinum at the time of diagnosis and thereafter (p<0.001) along with increasing age (p<0.01) and diabetes mellitus (p=0.08). Switching patients from continuous positive airways pressure support to oxygen or high flow nasal oxygen after the diagnosis of pneumomediastinum was not associated with difference in mortality.ConclusionsPneumomediastinum appears to be a marker of severe COVID-19 pneumonitis. The majority of patients in whom pneumomediastinum was identified had not been mechanically ventilated at the point of diagnosis.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Pneumomediastinum in COVID-19: a phenotype of severe COVID-19 pneumonitis? The results of the UK POETIC survey

et al. 2022

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“…The pain is usually substernal and aggravated by movement, breathing, and position changes. Other common symptoms include localized symptoms such as neck pain, dysphagia (like in the presented case), and dysphonia ( 6 ). Probably due to the patients’ good physical condition and because an athlete may not associate symptoms with a specific traumatic event during sports usually there is a delay in presentation to the emergency department ( 5 ).…”

Section: Discussionmentioning

confidence: 69%

Spontaneous Pneumomediastinum in a Teenager After Physical Exercise: a Benign and Rare, but Sometimes Challenging, Entity

et al. 2020

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Introduction: Pneumomediastinum defines a condition in which free air is present in the mediastinum usually caused by alveolar rupture resulting from a sudden increase in the intrathoracic pressure and air tracking along the tracheobronchial tree. Case report: We present a case of a 16-year-old male patient referred to our department due to persisting odynophagia, and retrosternal chest pain. A performed chest-CT revealed presence of free air in the mediastinum, without evidence of pneumothorax, or subcutaneous emphysema. Under the diagnosis of spontaneous pneumomediastinum (SPM) the treatment included conservative therapy with analgesics, rest, and oxygen. Conclusion: SPM is a rare benign condition with nonspecific presenting clinical signs; thus its diagnosis remains mostly one of exclusion. Thorough history-taking, beside radiographic studies, may be the key to confirm the diagnosis.

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“…The classic clinical triad is described by Hammam consists of pleuritic chest pain, dyspnea, and subcutaneous emphysema. [ 4 ] It is known to cause dyspnea in 49%, cough in 36%, neck pain in 36%, and dysphagia in 18% of the affected population. [ 5 ] SPM is typically a benign condition.…”

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confidence: 99%

Air! Places We Not Ought to See It

Kumar

Sharma

et al. 2021

Indian Journal of Nuclear Medicine

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Spontaneous pneumomediastinum is a rare condition, characterized by the presence of air in the mediastinum without any apparent precipitating cause. It is mainly a radiological diagnosis. The onus of differentiating between secondary and spontaneous pneumomediastinum lies on a thorough workup. In addition to etiology, complications such as tension pneumomediastinum, cervical emphysema, and pneumorachis. When present, must be diagnosed promptly. Spontaneous pneumomediastinum is a benign condition which is usually managed conservatively. Although not routinely seen on positron emission tomography/computed tomography, when present, they must be picked up and reported accurately to guide appropriate management of the patient.

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Spontaneous pneumomediastinum: Experience in 13 patients

Cited by 5 publications

References 7 publications

Pneumomediastinum in COVID-19: a phenotype of severe COVID-19 pneumonitis? The results of the UK POETIC survey

Pneumomediastinum in COVID-19: a phenotype of severe COVID-19 pneumonitis? The results of the UK POETIC survey

Spontaneous Pneumomediastinum in a Teenager After Physical Exercise: a Benign and Rare, but Sometimes Challenging, Entity

Air! Places We Not Ought to See It

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