[Spontaneous pneumomediastinum as a complication of asthma in adultsand adolescents].

The objective of this study was to examine the percent of spontaneous pneumomediastinums (SPM) as a complication of asthma in children and adolescent, and to examine the symptoms and clinical signs which predict SPM. A retrospective analysis was performed of patients discharged from Srebrnjak Hospital between 1988 and 1991 with the diagnoses of asthma and SPM. Ten cases (8 males and 2 females) aged 4-19 years were compared with 50 hospitalized patients. SPM was found in 4.96% of patients. Mean age of patients with SPM and asthma was 11.2 and of control patients 11.45 years. Chest pain was reported in 5/10 patients with SPM and asthma and in 0/50 of controls (p < 0.01). Subcutaneous emphysema was detected in 9/10 patients with SPM and asthma and in 0/50 of controls (p < 0.01). There was no difference in respiratory distress, partial oxygen pressure and oxygen saturation, heart rate and respiratory rate between cases and controls (p > 0.05). Systolic pressure was higher in children with SPM, but the values were within normal limits. During hospitalization in 3 patients with SPM partial left pneumothorax developed, in 1 partial bilateral pneumothorax and in 2 pneumopericardium. Subcutaneous emphysema is a significant specific clinical sign, and chest pain is a predominant symptom in the diagnosis of SPM. The patients with asthma and SPM must be treated in hospital because of potential further complication.