Yoneyama H, Matsushima T, Nakamura J, Yano T, Adachi M, Tano Y
Second Department of Internal Medicine, Kawasaki Hospital, Kawasaki Medical School, Okayama City, Japan.
Nihon Kyobu Shikkan Gakkai Zasshi. 1990 Jan;28(1):151-5.
Two cases of spontaneous pneumomediastinum and subcutaneous emphysema were reported. The first cases was a 21-year-old man who had a past history of recurrent spontaneous pneumothorax. The second was a healthy 20-year-old man. They were admitted to our hospital because of dyspnea and chest pain, which occurred at or after vocal exercise for Xiao-lin Temple boxing. Physically, a mediastinal crunch on auscultation heard over the cardiac apex and the left sternal border (Hamman's sign) was recognized in the first case, and subcutaneous emphysema was palpated in both cases. The chest X-ray films revealed intramediastinal air and subcutaneous emphysema in both cases. We diagnosed these patients as spontaneous pneumomediastinum because of no underlying disease. This is a report of rare cases of spontaneous pneumomediastinum occurring at the same time, and one of the mechanism causing them was considered to be a sudden increase in intrathoracic pressure due to the vocal exercise of chinese boxing.
报告了两例自发性纵隔气肿和皮下气肿病例。第一例是一名21岁男性，既往有复发性自发性气胸病史。第二例是一名健康的20岁男性。他们因小林寺拳法发声练习时或之后出现呼吸困难和胸痛而入院。体格检查时，第一例在心尖和左胸骨缘听诊可闻及纵隔摩擦音（Hamman征），两例均触及皮下气肿。胸部X线片显示两例均有纵隔内积气和皮下气肿。由于无基础疾病，我们将这些患者诊断为自发性纵隔气肿。本文报告了罕见的同时发生的自发性纵隔气肿病例，其中一个致病机制被认为是中国拳法发声练习导致胸腔内压力突然升高。
