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DOI: 10.1055/s-2008-1039059
© Georg Thieme Verlag KG Stuttgart · New York
Diagnosis and Treatment of Spontaneous Pneumomediastinum
Publication History
received July 13, 2008
Publication Date:
20 May 2009 (online)
![](https://www.thieme-connect.de/media/thoracic/200904/lookinside/thumbnails/10.1055-s-2008-1039059-1.jpg)
Abstract
Background: Due to its rarity there is no clear policy on the management of spontaneous pneumomediastinum (SPM). Methods: We treated 23 SPM patients between January 1 996 and November 2 006. There were 20 males and 3 females and their mean age was 27. Clinical records of the patients were collected and analyzed. Results: The most frequent symptoms were neck swelling (n = 20) and rhinolalia (n = 15). Onset of the symptoms was acute. A preceding factor was found in 19 (83 %) patients; these included vigorous cough, forced physical activity, vigorous sneezing and enormous efforts during spontaneous vaginal delivery. Chest X‐ray was sufficient to show mediastinal free air in 18 patients. Computerized chest tomography showed pneumomediastinum in all patients. Twenty patients were treated expectantly. Subcutaneous air drainage was needed to drain massive subcutaneous emphysema in three patients. Conclusions: Acute onset of typical symptoms, the existence of a preceding factor and the exclusion of other possible causes of pneumomediastinum with the help of CT are sufficient to make a diagnosis of SPM. A surgical intervention is generally not needed for the treatment of this entity.
Key words
thoracic surgery - spontaneous pneumomediastinum - diagnosis and treatment
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Dr. MD Mehmet Zeki Gunluoglu
Yedikule Chest Diseases and Thoracic Surgery Education and Research Hospital
Thoracic Surgery
Yedikule Gogus Hastanesi, 2. cerrahi klinigi, Zeytinburnu
34000 Istanbul
Turkey
Phone: + 90 21 26 64 17 00
Fax: + 90 21 25 47 22 33
Email: mzekigun@gmail.com