Bosscher M R Frederiek, Olie-García Karolien H, van Aalderen Wim M C
Rode Kruis Ziekenhuis, afd. Kindergeneeskunde, Beverwijk, The Netherlands.
Ned Tijdschr Geneeskd. 2011;155(41):A3388.
Pneumomediastinum is a rare, benign condition in which air leaks through the alveolar membrane and collects in the mediastinum. Typical clinical symptoms include chest pain and dyspnoea. In the absence of underlying pathology, conservative treatment is sufficient for remission. Complications are infrequent.
We present a case of a 14-year-old boy with pneumomediastinum arising during physical exercise after an earlier episode of coughing. Physical examination showed subcutaneous emphysema in the neck and praecordial systolic crepitations. A chest X-ray revealed air in the mediastinum. Conservative treatment was sufficient for full clinical and radiographic recovery.
There was no underlying pathology. The diagnosis was therefore a 'spontaneous pneumomediastinum' possibly caused by a Valsalva manoeuvre after physical exercise and chronic coughing.
纵隔气肿是一种罕见的良性病症，空气通过肺泡膜漏出并积聚在纵隔内。典型的临床症状包括胸痛和呼吸困难。在没有潜在病理状况的情况下，保守治疗足以实现病情缓解。并发症并不常见。
我们报告一例14岁男孩，在先前咳嗽发作后进行体育锻炼时出现纵隔气肿。体格检查发现颈部皮下气肿和心前区收缩期捻发音。胸部X线检查显示纵隔内有气体。保守治疗足以实现临床和影像学完全恢复。
不存在潜在病理状况。因此，诊断为“自发性纵隔气肿”，可能由体育锻炼后用力呼气动作和慢性咳嗽引起。
