HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Manuel Caceres Darryl Weiman Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Caceres, M. Articles by Garrett, H. E. Search for Related Content PubMed PubMed Citation Articles by Caceres, M. Articles by Garrett, H. E., Jr Related Collections Lung - other

---

Original Articles: General Thoracic

Spontaneous Pneumomediastinum: A Comparative Study and Review of the Literature

^a Department of Cardiothoracic Surgery, Appalachian Regional Healthcare, Hazard, Kentucky
^b Department of Cardiothoracic Surgery, University of Tennessee HSC, Memphis, Tennessee
^c Louisiana State University, Baton Rouge, Louisiana
^d Department of Cardiothoracic Surgery, Baptist Memorial Hospital, Memphis, Tennessee

Accepted for publication April 21, 2008.

^_* Address correspondence to Dr Garrett, 6029 Walnut Grove Rd, Suite 401, Memphis, TN 38120 (Email: egarrettmd{at}cvsclinic.com).

Background: Spontaneous pneumomediastinum (SPM) is an unusual occurrence with few cases reported. It is seen after intrathoracic pressure changes leading to alveolar rupture and dissection of air along the tracheobronchial tree. This study was undertaken to provide a thorough clinical and radiologic analysis of this patient population.

Methods: A retrospective comparative analysis was performed on patients with SPM over 12 years. Patient demographics, clinical presentation, and radiographic and diagnostic studies were recorded. A clinical and radiologic comparison was performed with secondary pneumomediastinum.

Results: Seventy-four patients were identified with a diagnosis of pneumomediastinum. A total of 28 patients with SPM were identified. The major initial complaints were chest pain (54%), shortness of breath (39%), and subcutaneous emphysema (32%). The main triggering events were emesis (36%) and asthma flare-ups (21%). No apparent triggering event was noted in 21% of patients. Chest radiograph was diagnostic in 69%; computed tomography was required in 31%. Esophagram, esophagoscopy, and bronchoscopy were performed on an individual basis and were invariably negative. When compared with secondary pneumomediastinum, SPM is more likely to be discovered by chest radiography, has a lower incidence of pneumothorax and pleural effusion, requires a shorter hospital stay, and has no associated mortality.

Conclusions: Spontaneous pneumomediastinum is a benign condition that often presents with chest pain or dyspnea. It can develop without a triggering event and with no findings on chest radiography. Treatment is expectant and recurrence is low. Secondary causes must be ruled out to avoid an unfavorable outcome.

This article has been cited by other articles:

				V. N. Iyer, A. Y. Joshi, and J. H. Ryu Spontaneous Pneumomediastinum: Analysis of 62 Consecutive Adult Patients Mayo Clin. Proc., May 1, 2009; 84(5): 417 - 421. [Abstract] [Full Text] [PDF]

				J. H. Ryu Unusual and Uncommon Pulmonary Disorders ACCP Pulmonary Med Brd Rev, January 1, 2009; 25(0): 479 - 486. [Full Text] [PDF]