Reddymasu Savio, Borhan-Manesh Fathali, Jordan Paul A
Department of Medicine, Louisiana State University Health Sciences Center, Shreveport, LA 71130, USA.
South Med J. 2006 Aug;99(8):892-3. doi: 10.1097/01.smj.0000220884.80266.95.
Spontaneous pneumomediastinum (SPM) is a rare and benign clinical entity characterized by free air around mediastinal structures. Precipitating factors include violent cough, asthma, inhalational drugs, labor and exercise. We report a case of SPM due to achalasia which to the best of our knowledge, has never been reported. In achalasia, Valsalva maneuver might accompany severe vomiting. This causes alveolar rupture due to elevated intrabronchial and intra-alveolar pressure. Air tracks along the mediastinal spaces cause SPM. In our patient, there was no evidence of esophageal perforation. Tension pneumomediastinum and pneumothorax are complications of SPM.
自发性纵隔气肿（SPM）是一种罕见的良性临床病症，其特征为纵隔结构周围出现游离气体。诱发因素包括剧烈咳嗽、哮喘、吸入性药物、分娩和运动。我们报告一例因贲门失弛缓症导致的SPM病例，据我们所知，此前从未有过相关报道。在贲门失弛缓症中，瓦尔萨尔瓦动作可能伴有严重呕吐。这会因支气管内和肺泡内压力升高导致肺泡破裂。气体沿纵隔间隙蔓延导致SPM。在我们的患者中，没有食管穿孔的证据。张力性纵隔气肿和气胸是SPM的并发症。
