Breakey R W F, Walker G, Oldfield W
Imperial College Healthcare NHS Trust, 46 High Street, Gosforth, Newcastle upon Tyne NE3 1LX, UK.
Ann R Coll Surg Engl. 2012 Nov;94(8):e243-5. doi: 10.1308/003588412X13373405387339.
This report discusses a case of spontaneous pneumomediastinum in a 25-year-old medical student. The patient presented with chest pain and a tonal change in voice. Symptoms occurred after an episode of stretching and were exacerbated by coughing. There was no history of underlying respiratory disease and he was a non-smoker. Management was conservative. At the four-week follow-up appointment, bronchoscopy and computed tomography of the thorax demonstrated complete resolution. Spontaneous pneumomediastinum is uncommon, with rhinolalia being a rare presenting feature. It should be considered as a differential diagnosis in patients with chest pain associated with a change in voice. A detailed history may reveal preceding activities associated with raised intrathoracic pressure.
本报告讨论了一名25岁医科学生的自发性纵隔气肿病例。患者表现为胸痛和声音音调改变。症状在一次伸展活动后出现,并因咳嗽而加重。无潜在呼吸系统疾病史,且不吸烟。治疗采取保守方法。在四周的随访预约中,胸部支气管镜检查和计算机断层扫描显示完全恢复。自发性纵隔气肿并不常见,鼻音是一种罕见的表现特征。对于伴有声音改变的胸痛患者,应将其视为鉴别诊断之一。详细的病史可能会揭示与胸腔内压力升高相关的先前活动。