An Interesting Cause of Acute Neck-Chest Pain and Dyspnea: Spontaneous Pneumomediastinum
Journal Title: Eurasian Journal of Family Medicine - Year 2017, Vol 6, Issue 2
Abstract
Spontaneous pneumomediastinum can defined as the presence of air in the mediastinum and it is a rare clinical entity. The formation mechanism is unclear but rise of alveolar and intrabronchial pressure is blamed for its formation. The most frequent triggers of spontaneous pneumomediastinum are acute asthma attack, diabetic ketoacidosis, smoking marijuana or cocaine, scuba diving, traveling by plane, excessive exercise, excessive vomiting or cough. Chest-neck pain and dyspnea are the main symptoms. Diagnosis can be confirmed mostly by chest radiography or thorax CT for suspected cases. The treatment of choice is oxygen, analgesics and monitoring the patient. It has a satisfactory outcomes and the recurrence is low. Surgical tretament may be necessary if tension pneumomediastinum, tension pneumothorax or mediastinitis determined. We report two cases with spontaneous pneumomediastinum. First one was an 17-year-old boy who presented emergency service with dyspnea, non-productive cough, chest-neck pain 8 h after the diving about 2 meter depth under the sea. Second one was a 20-year-old woman presented emergency service with acute dyspnea and chest pain. She was complained severe cough 2 days ago in her history. In both patients chest radiography and thorax CT revealed pneumomediastinum and subcutaneous emphysema. The patients admitted to the hospital for conservative treatment and follow up. They were discharged without any problems after follow up with control chest radiography. If patients refer to emergency department with dyspnea, acute neck and chest pain, spontaneous pneumomediastinum should be remembered. Although rare in the literatüre, this condition can develop while diving tubeless or with severe coughing.
Authors and Affiliations
Fazlı Yanık, Yekta Altemur Karamustafaoglu, Yener Yoruk
Keywords
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