Spontaneous Pneumomediastinum: Report of a Case and Review of Literature
2003
Spontaneous pneumomediastinum, defined as the presence of free air in the mediastinal structures, is a rare disease that usually take a good course with conservative therapy. However, clinicians are usually unfamiliar with the disease because of its infrequency. We report herein a case of spontaneous pneumomediastinum following an episode of violent cough. The patient was treated conservatively after hospitalization and got well without any medical problems. In addition we reviewed characteristics of spontaneous pneumomediastinum reported so far in the Japanese literature. The result of our review suggests that the typical patient with spontaneous pneumomediastinum is a young man with a slender build. In most patients, spontaneous pneumomediastinum occurs in conjunction with condition causing high airway pressure. None of the patients described in the literature developed serious complications such as cardiac insufficiency or airway compromise, and none of the cases without concomitant pneumothorax required any medical care. In conclusion, familiarity with this rare disease is crucial to provide appropriate treatment. ACTA MEDICA NAGASAKIENSIA 48: 67-70, 2003 condition is caused by a sustained increase in the intraalveolar and intrabronchial pressure with extravasated air dissecting along the perivascular spaces of the mediastinum." SPM is a rare disease that usually takes a good course with conservative therapy.2' However, clinicians are usually unfamiliar with the disease because of its infrequency. This unfamiliarity sometimes results in a missed or delayed diagnosis. We report herein a case of SPM following an episode of violent cough. To improve clinical recognition of this disease, we reviewed characteristics of SPM presentation as reported in the Japanese literature.
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