Russo Antonella, Giangregorio Carlo
S.O.C. Medicina e Chirurgia d'Accettazione e d'Urgenza - Pronto Soccorso Chirurgico, ASL Roma G, P.O. "Parodi Delfino" Colleferro, Roma.
Ann Ital Chir. 2012 Jan-Feb;83(1):13-9.
Early identification of spontaneous pneumomediastinum can be achieved by thoracic ultrasound in emergency.
A spontaneous pneumomediastinum in a 24 -year old man is reported.
The patient, who refused hospitalization, returned 12 hours later, complaining a massive subcutaneous emphysema, with a mild dyspnea. Thoracic CT confirmed suspected pneumomediastinum and the young man has been transferred to specialized DEA, with a good outcome by conservative treatment.
Revaluation of the patient has been useful to critically analyze the unusual echographic report too. The major sensitivity and specificity of thoracic US, compared to conventional supine X-ray, is more and more appreciated, regarding occult pneumothoraces. Furthermore the recruitment of training to detect penumomediastinum is needed.
Spontaneous pneumomediastinum is an extremely rare benign complications of chronic asthma in young population, caused by increased alveolar pressure, instrumental investigation may be supported by US in emergency too, associated to conventional X-ray and CT.
在急诊中，胸部超声可实现对自发性纵隔气肿的早期识别。
报告了一名24岁男性的自发性纵隔气肿病例。
该患者拒绝住院，12小时后返回，主诉有大量皮下气肿及轻度呼吸困难。胸部CT证实了疑似纵隔气肿，该青年男子已被转至专门的急诊部，经保守治疗后预后良好。
对该患者的重新评估也有助于批判性地分析这份不同寻常的超声报告。与传统仰卧位X线相比，胸部超声在检测隐匿性气胸方面具有更高的敏感性和特异性，这一点越来越受到认可。此外，还需要开展针对检测纵隔气肿的培训。
自发性纵隔气肿是年轻人群中慢性哮喘极为罕见的良性并发症，由肺泡压力升高引起，在急诊中，除了传统的X线和CT检查外，超声检查也可能有助于辅助诊断。
