自发性纵隔气肿患者无需进行食管造影和食管镜检查。

Oesophagography and oesophagoscopy are not necessary in patients with spontaneous pneumomediastinum.

机构信息

134 Sinchon-dong, Seodaemun-gu, CPO Box 8044, Seoul 120-752, South Korea;

出版信息

Emerg Med J. 2010 Jan;27(1):29-31. doi: 10.1136/emj.2008.065565.

DOI:10.1136/emj.2008.065565

PMID:20029003

Abstract

BACKGROUND

Because the condition is rare, the proper assessment of spontaneous pneumomediastinum (SPM) remains controversial. The purpose of this study was to determine whether additional oesophageal investigations beyond chest x ray and chest computed tomography (CT) scan are necessary for the diagnosis of SPM.

METHODS

The medical records of 25 patients diagnosed and treated for SPM from March 1986 to December 2007 were retrospectively reviewed.

RESULTS

There were 22 men and 3 women, with a median age of 19 years (range 15-57 years). All patients received chest x rays, which revealed air shadows within the mediastinum or subcutaneous emphysema in 24 patients. Twenty-two patients underwent chest CT scans, which showed pneumomediastinum in all cases. Oesophagography was performed in 14 patients and oesophagoscopy in three. All oesophagographies and oesophagoscopies were clear. Despite conservative treatment, no patients developed mediastinitis or complications associated with oesophageal injury.

CONCLUSIONS

Chest x ray and CT scan are sufficient to diagnose SPM. Additional diagnostic assessments such as oesophagography and oesophagoscopy are not necessary in patients without evidence of mediastinitis or a history of oesophageal injury.

摘要

背景

由于这种情况比较罕见，因此对自发性纵隔气肿（SPM）的正确评估仍存在争议。本研究旨在确定除了胸部 X 射线和胸部计算机断层扫描（CT）扫描之外，是否需要进行其他食管检查来诊断 SPM。

方法

回顾性分析了 1986 年 3 月至 2007 年 12 月期间诊断和治疗的 25 例 SPM 患者的病历。

结果

男性 22 例，女性 3 例，中位年龄为 19 岁（范围 15-57 岁）。所有患者均接受了胸部 X 射线检查，其中 24 例显示纵隔内有空气阴影或皮下气肿。22 例患者进行了胸部 CT 扫描，均显示纵隔气肿。14 例行食管造影，3 例行食管镜检查。所有食管造影和食管镜检查均清晰。尽管进行了保守治疗，但没有患者发生纵隔炎或与食管损伤相关的并发症。