Booms Zachary C, Barbee George A
J Am Osteopath Assoc. 2015 May;115(5):338-41. doi: 10.7556/jaoa.2015.065.
Pneumomediastinum occurs as a result of traumatic or iatrogenic causes or in patients with preexisting lung conditions such as interstitial lung disease, asthma, and chronic obstructive pulmonary disease. Spontaneous pneumomedi-astinum (SPM), however, is rarely seen in clinical practice. The authors report the case of a 14-year-old boy who presented to the emergency department with chest discomfort and shortness of breath after a 1600-m run as part of a physical education class. The patient was found to have SPM, was admitted to the pediatric service for monitoring and pain control, and made a full recovery within 24 hours. This case is notable because SPM occurred in the absence of identifable organic causes and as the result of sustained noncontact physical activity. A review of the literature provides background information and highlights pathophysiologic processes of SPM and suggested treatment. Physicians should consider pneu-momediastinum in young patients or runners presenting with chest pain even in the absence of any known inciting event.
纵隔气肿可由创伤或医源性原因引起，也可发生于患有间质性肺病、哮喘和慢性阻塞性肺疾病等肺部疾病的患者。然而，自发性纵隔气肿（SPM）在临床实践中很少见。作者报告了一例14岁男孩的病例，该男孩在体育课上进行1600米跑步后出现胸部不适和呼吸急促，到急诊科就诊。该患者被诊断为SPM，因监测和控制疼痛入住儿科病房，并在24小时内完全康复。该病例值得注意，因为SPM发生时没有可识别的器质性原因，而是持续非接触性体育活动的结果。文献回顾提供了背景信息，突出了SPM的病理生理过程及建议的治疗方法。即使在没有任何已知诱发事件的情况下，医生也应考虑年轻患者或跑步者出现胸痛时可能存在纵隔气肿。
