Mihos Petros, Potaris Konstantinos, Gakidis Ioannis, Mazaris Evangelos, Sarras Emmanuel, Kontos Zois
Department of General Thoracic Surgery, K.A.T. General Hospital of Attica, Kifissia, Greece.
Ann Thorac Surg. 2004 Sep;78(3):983-6. doi: 10.1016/j.athoracsur.2004.03.017.
Spontaneous pneumomediastinum is a rare medical entity occurring almost exclusively in otherwise healthy young individuals without known predisposing factors. We reported our experience with patients presenting with spontaneous pneumomediastinum related to sports.
Between January 1991 and December 2002, 10 patients were admitted with spontaneous pneumomediastinum related to sporting activities. We retrospectively reviewed their medical records with regard to predisposing factors, clinical presentation, diagnostic evaluation, and outcome.
The mean age of our patients was 18.9 years (range 15 to 25 years). Retrosternal chest pain was the most common symptom (90%), and subcutaneous emphysema the most common physical finding (90%). Hamman's sign was present in 9 patients. In all 10 patients, physical exertion during sports was the only implicating factor (scuba diving in 4 patients, basketball in 2, soccer in 3, and volleyball in 1). All patients were treated conservatively. Complete resorption of the pneumomediastinum occurred in 3 to 8 days. Hospital stay ranged from 2 to 6 days (mean 3.8 days). Follow-up was complete in 8 patients (80%), and ranged from 6 to 84 months (mean 35 months). Only 1 recurrence of pneumomediastinum was found that was treated similarly.
Spontaneous pneumomediastinum after sporting activities is a benign disease that generally resolves without clinical sequelae. Restriction of physical and athletic activity after the first episode is unnecessary, the only exception being that of scuba diving.
自发性纵隔气肿是一种罕见的医学病症，几乎仅发生于无已知诱发因素的健康年轻个体。我们报告了我们对与运动相关的自发性纵隔气肿患者的诊治经验。
1991年1月至2002年12月期间，10例因与体育活动相关的自发性纵隔气肿入院。我们回顾性分析了他们的病历，内容包括诱发因素、临床表现、诊断评估及治疗结果。
我们患者的平均年龄为18.9岁（范围15至25岁）。胸骨后胸痛是最常见症状（90%），皮下气肿是最常见体征（90%）。9例患者出现Hamman征。所有10例患者中，运动时的体力活动是唯一相关因素（4例潜水、2例篮球、3例足球、1例排球）。所有患者均接受保守治疗。纵隔气肿在3至8天内完全吸收。住院时间为2至6天（平均3.8天）。8例患者（80%）完成随访，随访时间为6至84个月（平均35个月）。仅发现1例纵隔气肿复发并接受了类似治疗。
运动后自发性纵隔气肿是一种良性疾病，通常可自行缓解且无临床后遗症。首次发作后无需限制体力和体育活动，唯一例外是潜水。
