Subcutaneous emphysema of the scrotum due to traumatic pneumothorax is a rare medical situation and only a few cases are reported in the literature. We present the case of a 22 year old man who was admitted to the emergency department after a motorcycle accident having a painless crepitant scrotum and chest excoriations. Further evaluation revealed subcutaneous emphysema of the scrotum caused by left pneumothorax. In conclusion, subcutaneous emphysema of the scrotum (or pneumoscrotum) due to traumatic pneumothorax is not an urgent condition and assessment should be supportive with intervention directed at the etiology, e.g. the pneumothorax.
Subcutaneous emphysema is a relatively rare complication of dental treatment, although increasingly due to the use of high pressure air instruments. Many cases go unrecognized or are misdiagnosed. Majority of patients with this complication resolve spontaneously after 5 to 10 days, however some can advance to potentially life-threatening complications. A case of subcutaneous emphysema during restorative procedure in a 52-year-old woman was treated in the Docent Odontological Clinic of the Frontera University is presented. The differential diagnosis and management of this condition is discussed. Our purpose is not to add one more case of emphysema to literature, but to show dentists that in simple restorative procedures using air pressure instruments, they could be exposed to this complication ...
Introduction: Subcutaneous and mediastinal emphysema is a rare complication after tonsillectomy. This case presentation and literature review summarizes the existing literature on this unusual complication. Materials and Methods: This study presents a case of a 21-year-old man who developed a cervical subcutaneous emphysema 6 days after tonsillectomy, whereby conservative treatment produced spontaneous resolution. A proper analysis of this case also required undertaking a systematic search in MEDLINE/PubMed and SCOPUS electronic databases concerning this rare complication, without language restrictions. Results: Based on our criteria, we identified 41 reports including 43 individual cases, in which patients were mostly young and equally distributed between the genders (17 males and 22 females, two unknown). The treatment was mainly conservative and consisted of observation and/or antibiotic therapy. Conclusion: Subcutaneous or mediastinal emphysema is an uncommon complication after tonsillectomy. It
Emphysematous cystitis (EC) is the presence of intramural gas, with or without luminal gas, within the bladder as a result of a primary infection of the lower urinary tract with a gas-producing organism. It is a well-recognised complication of urinary tract infections involving Escherichia coli in diabetic patients. Clinical subcutaneous emphysema is a rare complication of EC that appears to have poor prognosis. Only careful clinical judgement, and a high degree of suspicion, will lead to its early diagnosis and treatment. Here, we report a case of subcutaneous emphysema due to EC based on a clinical diagnosis confirmed using computed tomography (CT).
Subcutaneous Emphysema is a condition that occurs when air gets into the tissue beneath the skin. Subcutaneous emphysema consist of
Although a rare complication of labor, subcutaneous emphysema and pneumomediastinum (Hammans syndrome) must be considered in the parturient complaining of chest or neck pain, dysphagia, or shortness of breath. With conservative management, the prognosis is favorable. The case presented is the first of Hammans syndrome complicating the labor of a twin gestation. The pathophysiology, symptoms, and management guidelines for the syndrome are reviewed. ...
TY - JOUR. T1 - Subcutaneous emphysema and pneumomediastinum in the postpartum period.. AU - Wall, E. M.. AU - Fields, Scott. AU - Pitre, C.. PY - 1992/3. Y1 - 1992/3. UR - http://www.scopus.com/inward/record.url?scp=0026827385&partnerID=8YFLogxK. UR - http://www.scopus.com/inward/citedby.url?scp=0026827385&partnerID=8YFLogxK. M3 - Article. C2 - 1575076. AN - SCOPUS:0026827385. VL - 5. SP - 223. EP - 224. JO - Journal of the American Board of Family Medicine. JF - Journal of the American Board of Family Medicine. SN - 1557-2625. IS - 2. ER - ...
El enfisema subcutáneo es una complicación poco frecuente en la práctica odontológica, que ha ido en aumento debido al uso de instrumentos con aire a presión. Muchos de los casos no son reconocidos o presentan un diagnóstico errado. La mayor parte de los p...
PubMed Central Canada (PMC Canada) provides free access to a stable and permanent online digital archive of full-text, peer-reviewed health and life sciences research publications. It builds on PubMed Central (PMC), the U.S. National Institutes of Health (NIH) free digital archive of biomedical and life sciences journal literature and is a member of the broader PMC International (PMCI) network of e-repositories.
Hammans syndrome (spontaneous subcutaneous emphysema and pneumomediastinum) is a rare complication of diabetic ketoacidosis (DKA), with a multifactorial etiology. Awareness of this syndrome is important: it is likely underdiagnosed as the main symptom of shortness of breath is often attributed to Kussmauls breathing and the findings on chest radiograph can be subtle and easily missed. It is also important to be aware of and consider Boerhaaves syndrome as a differential diagnosis, a more serious condition with a 40% mortality rate when diagnosis is delayed. We present a case of pneumomediastinum, pneumopericardium, epidural emphysema and subcutaneous emphysema complicating DKA in an eighteen-year-old patient. We hope that increasing awareness of Hammans syndrome, and how to distinguish it from Boerhaaves syndrome, will lead to better recognition and management of these syndromes in patients with diabetic ketoacidosis. ...
Hammans syndrome (spontaneous subcutaneous emphysema and pneumomediastinum) is a rare complication of diabetic ketoacidosis (DKA), with a multifactorial etiology. Awareness of this syndrome is important: it is likely underdiagnosed as the main symptom of shortness of breath is often attributed to Kussmauls breathing and the findings on chest radiograph can be subtle and easily missed. It is also important to be aware of and consider Boerhaaves syndrome as a differential diagnosis, a more serious condition with a 40% mortality rate when diagnosis is delayed. We present a case of pneumomediastinum, pneumopericardium, epidural emphysema and subcutaneous emphysema complicating DKA in an eighteen-year-old patient. We hope that increasing awareness of Hammans syndrome, and how to distinguish it from Boerhaaves syndrome, will lead to better recognition and management of these syndromes in patients with diabetic ketoacidosis. ...
Dentist and nurse anesthetist-wife try frozen green peas to reduce massive subcutaneous emphysema following wisdom tooth surgery under general anesthesia; patient has permanent lingual paresthesia; Florida settlement for $96,250.. Plaintiff was a 24 year-old single woman when she first visited the general dentist with complaints referable to her lower third molar teeth. She was told that she should have the teeth extracted and she told the dentist that she wanted a general anesthetic. He offered to refer her to an oral surgeon or, if she was willing to wait for the dentist to receive something from the state, she could return to him and he would be able to do the surgery under general anesthesia. He was, at the time, awaiting receipt of an anesthesia/parenteral sedation permit from the Florida Board of Dentistry.. More than six months later, he called the patient back into his office to schedule her surgery. The dentists wife was a CRNA (nurse anesthetist) and would do the anesthesia. The ...
Pneumorrhachis is defined as the presence of air in the epidural space or subarachnoid space. The air may migrate along fascial planes from the posterior mediastinum, through the neural foramina, and into the epidural space. Pneumorrhachi
An 83-year-old woman was brought to the emergency department (ED) by the Emergency Medical Services (EMS) due to referred anaphylactic shock. While eating, she started choking and her neck and lips swelled. Upon arrival at the ED she was confused, tachycardic and hypotensive (heart rate 130 bpm, blood pressure 86/40 mm Hg); the hypotension was slightly improved by colloid and dopamine infusion. A … ...
Byvny RL, Shockley LW. Scuba diving and dysbarism. In: Marx JA, Hockberger RS, Walls RM, et al, eds. Rosens Emergency Medicine: Concepts and Clinical Practice. 8th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 143.. Cheng G-S, Varghese TK, Park DR. Pneumomediastinum and mediastinitis. In: Broaddus VC, Mason RJ, Ernst JD, et al, eds. Murray and Nadels Textbook of Respiratory Medicine. 6th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 84.. Eckstein M, Henderson SO. Thoracic trauma. In: Marx JA, Hockberger RS, Walls RM, et al, eds. Rosens Emergency Medicine: Concepts and Clinical Practice. 8th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 45.. Kosowsky JM, Kimberly HH. Pleural disease. In: Marx JA, Hockberger RS, Walls RM, et al, eds. Rosens Emergency Medicine: Concepts and Clinical Practice. 8th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 77. ...
They also said that she has subcutaneous emphysema which is when some of the air leaks out of the chest tube and gets stuck between the muscles. For her it is in between the muscles behind her shoulder and in her left side under her arm. This too is really painful and can move around a bit from the incision/lung site so this could explain a lot of what Tam is experiencing in her chest as well. In addition we were told that they saw some apical scaring on the lung and that there was still a small pneumothorax present after the chest tube was removed in addition to a UTI because of being repeatedly straight-cathed last week after the surgery. They are hoping that the small pneumothorax and the subcutaneous emphysema heals on its own in time and she is receiving high strength IV meds for the UTI. We are being told that some of this is common (finally) and can be happen with chest tubes, so they are hoping it resolves itself. We just really need to get the inflammation and the painful subcutaneous ...
Subcutaneous emphysema is a known complication of chest drains. Clinically it presents with extreme discomfort, anxiety or upper airway obstruction. It is known to occur with prolonged drainage, tube blockage, side port migration or poor tube p...
​I was diving over the weekend, doing three dives each day, finishing about noon on Sunday. I had some trouble clearing on both days, and on the last dive I had a reverse squeeze. I can hear just fine and I dont have any pain, but on the side of my neck I have several little bubbles that I can press on but which are not painful. Have you ever heard of this? ​Air bubbles dont normally exist unde...
Free, official info about 2015 ICD-9-CM diagnosis code 958.7. Includes coding notes, detailed descriptions, index cross-references and ICD-10-CM conversion info.
Open fractures of the pelvis are associated with high energy trauma and present a challenge to successful management and sometimes, early and correct diagnosis. These patients require more aggressive blood resuscitation particularly in the first 24 hours, repeated wound care operations, and often require a diverting colostomy. Usually these pelvic fractures can be distinguished from closed pelvic fractures by an open wound or lacerations of the vagina and rectum. Occasionally, however, the wounds associated with these fractures may remain undetected and the severity of the injury underestimated until complications develop. The authors believe this to be the first report of subcutaneous surgical emphysema associated with an open pelvic fracture.. ...
We present a case of laryngeal oncocytic cysts presenting as bilateral laryngoceles and surgical emphysema of the neck. Although there is a rare, but well-documented association of laryngoceles with l
Tracheobronchial injuries are life threatening and often are not recognized in the acute setting.1 The right main bronchus is most frequently affected.1 Commonly observed radiologic findings are pneumothorax, pneumomediastinum, subcutaneous emphysema, clavicle fracture, rib fractures, pulmonary contusion, widened mediastinum, and hemothorax.2 Clinical features include sternal tenderness, dyspnea, hemoptysis and Hamman sign (a crunching, rasping sound heard over the precordium, synchronous with the heartbeat, produced by the heart beating against air-filled tissues in the mediastinum). Bronchoscopy is the gold standard for diagnosis.3 ...
Case #3. Motorcycle accident. Patient transferred with reservoir facial mask and PCC. The patient was in pain and showed 2 incised and lacerated wounds in the anterior region of the neck with spontaneous air leak and significant subcutaneous emphysema. The chest X-ray performed confirmed the presence of one pneumothorax that started with HS but showed progressive dyspnea that required chest drain in situ. The CT scan showed 3 lines of fractures in the TC and solution of continuity of the mucosa (Fig. 1B). The patient was transferred with PAW straight to the operating room where tracheostomy and ORIF procedures were performed.. Case #4. Physical aggression transferred with reservoir facial mask. The patient showed facial edema and cervical emphysema and complained of pain and dysphonia. Since the AW was compromised, it was decided to proceed with an urgent OTI with Airtraq® using the FROVA® intubating introducer with Cormack-Lehane grade iv. The CT scan confirmed the presence of one sagittal ...
Our team aims to provide the most robust and innovative care available to treat emphysema. We are specialists in all aspects of COPD care, ranging from minimally-invasive endobronchial procedures to lung volume reduction and transplant surgery.
b.Thoracentesis (Left and Right). ● Air can be introduced to create swelling of the left or right side of the chest (tension pneumothorax, subcutaneous emphysema).. ● Distension of the jugular vein can be simulated in conjunction with the swelling of the chest.. ● Sternal angle and second intercostal space are present for use as landmarks for the puncture site.. ● Upon puncture, the air flows out, and the swelling of the chest and distension of the jugular vein subside.. ● When there is a syringe attached to the puncture needle, air pressure will lift the plunger.. ● The skin is made with silicone, giving it an appearance and texture similar to the real thing, making training more. realistic.. ...
Chest trauma, a major cause of subcutaneous emphysema, can cause air to enter the skin of the chest wall from the neck or lung ... in penetrating trauma of the chest, air may travel from the lung to the muscles and subcutaneous tissue of the chest wall ... the alveoli of the lung are ruptured, as occurs in pulmonary laceration, air may travel beneath the visceral pleura (the membrane lining the lung), to the hilum of the lung ...
This case study reports on a 17-year-old male who reported to the pediatrician at a local rural hospital with complaints of pretibial pain in his right leg, after he accidentally cut his leg while in the fields a few days earlier. He was diagnosedfor having aphlegmon with an abscess followed by surgical debridement with wound nettoyage with no clinical signs of subcutaneous emphysema or necrotising fasciitis. Postoperatively the patients condition deteriorated and after admission to ICU he developed erythema, spreading from the right lower leg to the right upper leg, abdominal wall and the left leg, consistent with toxic shock syndrome and subsequent development of septic shock due to invasive S. aureus infection with respiratory failure, hemodynamic instability treated with vasopressors, hydrocortisone, antibiotic therapy. Due disease severity, CRRT was initiated with a CytoSorbadsorber with the only goal to remove cytokines (despite absence of acute kidney injury and no need for renal ...
she is still on the brink. i havent walked out to see her this morning but she was with us last night. i returned her calf, Jocelyn, to her and am administering a couple of medicines (antibiotics and pain relief) around the clock. she has been experiencing some of the serious complications i mentioned, specifically subcutaneous emphysema (air trapped under her skin) all along the left side of her body where she was pierced. the concern is that this air is from her rumen and includes bacteria from it. the resulting infection, peritonitis, would most likely be fatal ...
TY - JOUR. T1 - Benign Pneumatosis Intestinalis with Subcutaneous Emphysema in a Liver Transplant Recipient. AU - Sachse, Rainer E.. AU - Burke, George VV. AU - Jonas, Maureen. AU - Milgrom, Martin. AU - Miller, Joshua. PY - 1990/7. Y1 - 1990/7. N2 - Pneumatosis intestinalis (PI) occurred in a pediatric liver transplant recipient experiencing chronic rejection. Signs and symptoms included abdominal distention, subcutaneous emphysema, fever, and malaise. Antibiotic treatment and nasogastric decompression resulted in prompt relief of symptoms, and surgery was not necessary. The etiology, pathophysiology, and therapy of this rare condition are discussed.. AB - Pneumatosis intestinalis (PI) occurred in a pediatric liver transplant recipient experiencing chronic rejection. Signs and symptoms included abdominal distention, subcutaneous emphysema, fever, and malaise. Antibiotic treatment and nasogastric decompression resulted in prompt relief of symptoms, and surgery was not necessary. The etiology, ...
The syndrome of acute mediastinal emphysema following trauma or pulmonary disease has been recognized for many years, but it is only recently that Hamman1, 2 has called attention to the spontaneous occurrence of this condition. Numerous case reports3-18 have been published following his description, but it is still regarded as a rare entity. Recently, moreover, reports of mediastinal emphysema secondary to other conditions have been less common than those of the spontaneous type. This subject is particularly important at the present time because many cases following trauma19 and influenzal pneumonia20, 21, 22 were reported during World War I and undoubtedly ...
Mediastinal emphysema: Mediastinal emphysema,, pocket of air surrounding the heart and central blood vessels contained within the mediastinum (the central cavity in the chest situated between the
Case Reports in Otolaryngology is a peer-reviewed, Open Access journal that publishes case reports in all areas of otolaryngology, including head and neck surgery, facial plastic and reconstructive surgery, maxillofacial surgery, and pediatric otolaryngology.
Orbital fractures are common injuries found in facial trauma. Typical etiologies of orbital fractures include motor vehicle collisions and assault. We report the case of a 32-year-old male who suffered an orbital fracture from a water balloon. Additionally, we describe the aeromedical complications that may result from this injury. Finally, we attempt to answer the question of when a patient may return to flying after sustaining such an injury through review of the literature. A 32-year-old male pilot with the United States Air Force was at an outdoor event with his unit when he was struck with a water balloon launched from a sling shot into his left orbit. Shortly afterwards, he had an onset of subcutaneous emphysema and was escorted to a nearby Emergency Department. Computed tomography identified an orbital fracture with associated orbital and subcutaneous emphysema. The patient was evaluated by a plastic surgeon and was determined not to be a surgical candidate. Four weeks later, he returned to
Lung fields are clear. There is mediastinal air present. Pleural margins show a small apical pneumothorax on the left and a trace apical pneumothorax on the right. Diffuse subcutaneous emphysema along anterior chest and both sides, as well as in the soft tissues of the neck. There is also intraperitoneal and retroperitoneal free air.
Copyright В 2004 Elsevier MEDIASTINAL EMPHYSEMA Air may enter the mediastinum from the esophagus, trachea, bronchi, lung, neck, or abdomen, producing mediastinal emphysema or pneumomediastinum. 0) duphaston can cause acne for radiation optic neuropathy was location of tumor within 1 DD of the optic disc (RR 6.
To the Editor:. Pneumothorax and spontaneous pneumomediastinum should be considered in an Ecstasy user who complains of chest pain, neck pain, or shortness of breath (1-5). We report a case of a patient who presented with subcutaneous cervical air emphysema and spontaneous pneumomediastinum associated with Ecstasy use.. A 27-year-old man was admitted to the hospital, complaining of sudden chest pain and dyspnea. He had taken one tablet of Ecstasy and was an occasional drug abuser. No history of trauma or surgery was reported. Initial examination showed cervicofacial and thoracic subcutaneous air emphysema. The initial chest radiograph showed emphysema in the cervicofacial, thoracic, and axillary regions with no evidence of rib fracture or pneumothorax. The results of the esophagogram, otolaryngologic examination, and bronchoscopy ruled out any abnormality. The chest CT demonstrated air in the subcutaneous, visceral, and carotid spaces of the neck, extending along the anterior mediastinal space. ...
A 31-year-old man, with no significant medical history, developed sudden onset central chest pain radiating across the upper chest wall and into the neck following sternutation (sneezing). There had been a preceding history of cocaine abuse by insufflation. On clinical examination, there was ulcerated nasal septum, palpable crepitus in the supraclavicular fossae, normal heart sounds and equal air entry to both lungs on auscultation.. His chest radiograph demonstrated bilateral supraclavicular surgical emphysema and pneumomediastinum (figure 1 … ...
Deep venous thromboses are thought to occur in as many as 1 in 1000 people annually1, although many instances never present to urgent care or emergency room settings. When a patient does make it to the ER, the most common presentation is a swollen, tender lower extremity. Although there are many things on the differential, the emergency room physician must rule out DVT because of the potential risk of subsequent pulmonary embolism.. Ultrasound has become the go-to method for evaluation of DVT. In the ER setting, the limited compression ultrasound technique is most widely used due to the ease and speed at which it can be performed. A duplex scan with color Doppler can be useful in other scenarios, but these evaluations can take up to an hour, require a skilled technician, and have not been shown to be any more accurate in detection of proximal DVTs compared to limited compression ultrasound2.. Limited compression ultrasound frequently targets two main locations for DVTs: the common femoral vein ...
In addition to pneumothorax, complications from thoracotomy include air leaks, infection, bleeding and respiratory failure. Postoperative pain is universal and intense, generally requiring the use of opioid analgesics for moderation, as well as interfering with the recovery of respiratory function. Paraplegia complicating thoracotomy is rare but catastrophic.[3][4] In nearly all cases a chest tube, or more than one chest tube is placed. These tubes are used to drain air and fluid until the patient heals enough to take them out (usually a few days). Complications such as pneumothorax, tension pneumothorax, or subcutaneous emphysema can occur if these chest tubes become clogged. Furthermore, complications such as pleural effusion or hemothorax can occur if the chest tubes fail to drain the fluid around the lung in the pleural space after a thoracotomy. Clinicians should be on the look out for chest tube clogging as these tubes have a tendency to become occluded with fibrinous material or clot in ...
To report on a patient who underwent a total thyroidectomy and re-presented three weeks later with significant subcutaneous emphysema due to a tracheal perforation.
A 46-year-old female with a history of asthma and anxiety presents to the emergency department (ED) with progressively worsening shortness of breath for 5 days. She states that her rescue inhaler is not giving her much symptom relief. In the ED, she was given multiple nebulizer treatments. The patient was admitted to the floor but had progressing shortness of breath and anxiety. She was still hypoxic (saturating 93% on room air), hypercapnic, and, thus, was transferred to the intensive care unit. Upon arrival, the patient was tachycardic, tachypneic, and sitting up in a tripod position. Her arterial blood gas showed a pH of 7.13, PCO2 of 95, and PO2 of 166. The decision was made to intubate the patient, which was done using video laryngoscopy with a 7.5mm endotracheal tube. The post-intubation film was unremarkable.. About 2 hours after the intubation, the family felt that her stomach and face looked swollen. At that time, she was noted to have subcutaneous emphysema of her neck and chest. The ...
On September 14, 2015, hosts from "The View" attacked Miss Colorado, RN Kelley Johnson, who gave a monologue about the value of nursing in the Miss America pageant. The monologue certainly could have given more specifics as to how nurses save lives, but we appreciate her attempts to highlight the value of nursing. (See Kelley Johnsons monologue.) In the middle of The Views take down of nurse Johnson, host Joy Behar asked indignantly: "Why is she wearing a doctors stethoscope around her neck?" (See The Views film clip.) Ms. Behar apparently has never had a nurse listen to her chest for cardiac defects or electrical irregularities, or for a signs of congestive heart failure, subcutaneous emphysema or pneumothorax. Nor apparently has a nurse ever taken her vital signs with a stethoscope. Basically Ms. Behar was asking how Ms. Colorado had the effrontery to be doing physician work, because she does not know nurses do anything technical, important or life-saving. Ms. Behar and The View owe nurses ...
We present a case of open fracture of maxillary sinus following fall against a nutcracker. The only pathological findings were a small wound and subcutaneous emphysema in the front of and behind the right maxillary sinus. There was no flattening of the anterior wall of the maxillary sinus, consequently no surgical intervention was performed. The patient was treated with prophylactic antibiotics and sutures. No sequelae were observed ...
Thus, the diagnosis of SPM was attained. The patient was hospitalized and treated with inhaled bronchodilators, analgesics, and maintained on the previously prescribed antibiotics. There was clinical and radiological improvement; the patient was discharged on the 5th day of hospitalization and referred to the pulmonology department for consultation. During this follow-up period there were no signs of recurrence. DISCUSSION. The physiopathological aspects involved in SPM were initially described by Macklin in 19441-4. He considered that the underlying factor was the rupture of terminal alveoli secondary to increased alveolar pressure, with consequent leakage of air into the peribronchial interstitial space and, from there, to the hilum and mediastinum. The air in the mediastinum can cross through the fascia and spread to the subcutaneous tissue of the chest and cervical regions, retropharyngeal space, peritoneum, retroperitoneum, and pericardium. This case shares many aspects with most cases ...
PubMed Central Canada (PMC Canada) provides free access to a stable and permanent online digital archive of full-text, peer-reviewed health and life sciences research publications. It builds on PubMed Central (PMC), the U.S. National Institutes of Health (NIH) free digital archive of biomedical and life sciences journal literature and is a member of the broader PMC International (PMCI) network of e-repositories.
This leaves the lung and smaller airways within it to consider. They are, by far, the most common sources of pneumomediastinum. The most common pattern is that this injury causes a small pneumothorax, which dissects into the mediastinum over time. On occasion, the leak tracks along the visceral pleura and moves directly to the mediastinum.. Management is simple: a repeat chest xray after 6 hours is needed to show non-progression of any pneumothorax, occult or obvious. This image will usually show that the mediastinal air is diminishing as well. There is no need for the patient to be kept NPO or in bed. Monitor any subjective complaints and if all progresses as expected, they can be discharged after a very brief stay.. ...
The haystack sign on chest x-rays in paediatric patients is indicative of pneumomediastinum. The paediatric heart is surrounded above and below with gas, giving it an appearance of a haystack from Monets paintings.
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Learn about the causes, symptoms, diagnosis & treatment of Mediastinal and Pleural Disorders from the Professional Version of the Merck Manuals.
Spontaneous pneumomediastinum is uncommon in paediatric practice. We describe two cases of spontaneous pneumomediastinum in a child and an adolescent with anorexia nervosa. Thorough investigation failed to reveal any underlying cause for secondary pneumomediastinum. Pneumomediastinum in anorexia nervosa can be caused by not only elevated intrathoracic pressures, but also by the poor quality of the alveolar walls due to malnutrition. The incidence of spontaneous pneumomediastinum in anorexia nervosa is probably higher than that recorded, since it resolves spontaneously and, therefore, it can remain undetected. We conclude that it is our considered opinion that malnutrition associated with anorexia nervosa predisposes for spontaneous pneumomediastinum due to weakness of the alveolar wall and the loss of connective tissue.