Ochoa-Ariza MF, Trejos-Caballero JL, Parra-Gelves CM, Camargo-Lozada ME, Laguado-Nieto MA

Language: Spanish
References: 12
Page: 438-442
PDF size: 450.30 Kb.

ABSTRACT

Background: Pneumomediastinum is defined as the presence of air in the mediastinum. It may appear after surgical procedures, trauma, or spontaneous. This last one is related with situations where the intra-alveolar pressure is increased, as in the Valsalva maneuvers, coughing, vomiting, among others. Asthma is a very frequent factor associated with spontaneous pneumomediastinum. It is developed due to the distension of the airways to the bronchial obstruction where the alveolar rupture occurs. It is a rare disease with a lot of differential diagnoses. The most common symptoms are chest pain, dyspnea and pain in the neck. The physical examination can show edema in the neck and subcutaneous emphysema. The initial study should be performed with chest radiography but up to the 30% could be normal, in this case it must be confirmed with chest tomography. The evolution is good and the treatment is generally conservative.
Clinical case: A 17-year-old female patient with moderate asthmatic attack, acute bronchitis with pneumomediastinum, pneumopericardium, for which it was indicated bronchodilator, corticosteroid and antibiotic treatment.
Conclusions: Spontaneous pneumomediastinum is a rare condition, with signs and symptoms that may suggest various diagnostic options, so clinical suspicion and diagnostic guidance are vital to prescribe the effective treatment.

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