Spontaneous pneumomediastinum secondary to acute stress reaction: a case report

Abstract

Objective: As spontaneous pneumomediastinum (PMS) is a rare and idiopathic entity, the present report proposes to record one of the few cases of a patient who presented PMS after intense cries induced by psychiatric illness. Case details: A 50-year-old male patient who was admitted to emergency department with agitation, cold sweating, tachycardia and echolalia, associated with screams. Symptoms lasted for about 15 hours and they have started after the patient witnessed a first-degree relative (father) dying at home due to COVID-19. A thorax computed tomography scan found a Pneumomediastinum that involved the upper mediastinum with mild extension to lower neck, near the Thyroid gland. After acute stress reaction diagnosis, accordingly with DSM-IV criteria, patient followed observation for two days and punctual benzodiazepines use, having no clinical complications during hospital stay. Pneumomediastinum was completely resolved. Final considerations: Screams motivated by psychiatric condition can be added to SPM causes list and should motivate phisician awareness, since it may bare life-threatening complications associated.

A Rare Case of Spontaneous Pneumomediastinum in a Female After Shouting: A Literature Review

“…The incidence of SPM increased, and this increment in number of documented cases could be attributed to the significant advancement in radiological imaging technology. Despite that, it is still considered a rare clinical condition [ 1 , 7 ]. SPM is more common in males as compared with females, and most patients are tall, healthy, thin males with ages ranging from 20 to 25 years [ 6 ].…”