Bodart E, de Bilderling G, Nisolle J F, Trigaux J P, Tuerlinckx D
Service de pédiatrie, Cliniques universitaires UCL de Mont-Godinne, Yvoir, Belgique.
Arch Pediatr. 1999 Dec;6(12):1293-6. doi: 10.1016/s0929-693x(00)88891-0.
A case of mediastinal emphysema occurring without etiologic factor except a Valsalva's manoeuvre a few hours before admission in a 15-year-old boy is reported. Symptoms were cervical and chest pain with moderate dysphagia. Diagnosis was confirmed by palpating subcutaneous air in the neck region and mediastinal air on a chest roentgenogram. A CT scan was performed to exclude a concurrent pneumothorax. The patient recovered with bed rest.
Spontaneous pneumomediastinum results from nontraumatic, mediastinal air leakage without underlying lung disease. It should be considered in the differential diagnosis of chest pain, especially in healthy adolescents and young adults; it is certainly underdiagnosed in this population.
报告了一例15岁男孩,除入院前数小时进行瓦尔萨尔瓦动作外无其他病因,发生了纵隔气肿。症状为颈部和胸部疼痛伴中度吞咽困难。通过触诊颈部皮下气肿及胸部X线片显示纵隔积气确诊。进行CT扫描以排除并发气胸。患者经卧床休息后康复。
自发性纵隔气肿由无潜在肺部疾病的非创伤性纵隔漏气引起。在胸痛的鉴别诊断中应考虑到该病,尤其是在健康的青少年和青年中;在这一人群中该病肯定存在诊断不足的情况。