Zaia Brita E, Wheeler Stephen
Department of Emergency Medicine, Alameda County Medical Center-Highland General Hospital, Oakland, California 94602, USA.
J Emerg Med. 2010 Feb;38(2):155-8. doi: 10.1016/j.jemermed.2007.02.066. Epub 2007 Nov 19.
A previously healthy 16-year-old boy presented to the Emergency Department with a 2-day history of hoarseness, sore throat, and chest tightness. The physical examination was significant for diffuse neck and chest subcutaneous emphysema. A computed tomography (CT) scan of the neck and chest revealed pneumomediastinum after a plain chest X-ray study failed to uncover this finding. The patient reported that 5 days before presentation he forcefully inhaled helium gas directly from multiple party balloons in an attempt to alter his voice. The patient fully recovered over the next 2 days. Spontaneous pneumomediastinum developed in this patient with no underlying lung disease, presumably from air leakage secondary to the excessive elevation of intra-thoracic pressure due to repetitive inhalation of helium gas. Spontaneous pneumomediastinum remains largely underdiagnosed clinically, especially in young, healthy patients.
一名既往健康的16岁男孩因声音嘶哑、咽痛和胸闷2天就诊于急诊科。体格检查发现颈部和胸部弥漫性皮下气肿。颈部和胸部计算机断层扫描（CT）显示纵隔气肿，而胸部X线平片检查未能发现这一情况。患者报告称，在就诊前5天，他为了改变声音，直接从多个派对气球中用力吸入氦气。患者在接下来的2天内完全康复。该患者无潜在肺部疾病却发生了自发性纵隔气肿，推测是由于反复吸入氦气导致胸腔内压力过度升高继发空气泄漏所致。自发性纵隔气肿在临床上很大程度上仍未得到充分诊断，尤其是在年轻健康的患者中。
