Division of Pediatric Cardiology and Pulmonology, Department of Pediatrics, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
Kaohsiung J Med Sci. 2010 Feb;26(2):84-8. doi: 10.1016/s1607-551x(10)70012-7.
Pneumomediastinum, the leakage of air or gas into the mediastinum, can be a primary or secondary diagnosis. Although spontaneous pneumomediastinum (SPM) is uncommon in pediatric respiratory disorders, it is potentially life-threatening. In this study, we investigated the associations between various etiologies and clinical presentations, hospital length-of-stay, and clinical outcomes of SPM. From January 2004 to December 2007, we collected medical records and chest films from 23 pediatric patients with SPM. Results showed that increased hospital length-of-stay was significantly associated with asthma (p = 0.035), dyspnea/tachypnea (p = 0.01), and emergent visit (p = 0.04). Dysphagia was associated with shorter hospital stay (p = 0.058). Besides, the disorder was misdiagnosed initially in 21% of patients. In conclusion, there may be close relationships between the predisposing factors of SPM and its clinical manifestations. The high rate of misdiagnosis highlights the importance of careful examination and history taking in pediatric patients with chest pain.
纵隔气肿，即空气或气体漏入纵隔，可以是原发性或继发性诊断。虽然自发性纵隔气肿（SPM）在儿科呼吸疾病中并不常见，但它可能具有生命威胁。在这项研究中，我们调查了各种病因和临床表现、住院时间和 SPM 的临床结果之间的关联。从 2004 年 1 月至 2007 年 12 月，我们收集了 23 例 SPM 儿科患者的病历和胸片。结果表明，哮喘（p = 0.035）、呼吸困难/呼吸急促（p = 0.01）和急诊就诊（p = 0.04）与住院时间延长显著相关。吞咽困难与住院时间缩短相关（p = 0.058）。此外，21%的患者最初被误诊。总之，SPM 的诱发因素与其临床表现之间可能存在密切关系。高误诊率强调了对有胸痛的儿科患者进行仔细检查和询问病史的重要性。
