Dirweesh Ahmed, Alvarez Chikezie, Khan Muhammad, Christmas Donald
Department of Internal Medicine, Seton Hall University School of Medicine, Saint Francis Medical Center, Trenton, NJ, USA.
Respir Med Case Rep. 2017 Feb 6;20:129-132. doi: 10.1016/j.rmcr.2017.01.014. eCollection 2017.
Spontaneous pneumomediastinum (SPM) is an uncommon finding in young adults presenting usually without any comorbidities or an underlying pathology. It is most commonly due to alveolar rupture in the setting of an inciting event such an underlying asthma, barotrauma, valsalva maneuver, or esophageal rupture. Individuals can have varying presentations, from chest pain, dyspnea and dysphagia, to anxiety, weakness, or facial and neck swelling. The majority of patients have subcutaneous emphysema on examination and can have abnormal laboratory findings such as an elevated C-reactive proteins and leukocytosis. Diagnostic modalities used include chest x-ray, CT scan, ultrasound and barium swallow or esophagram. Majority of individuals and treated conservatively with rest, analgesia and oxygen administration. The prognosis of SPM is usually good with resolution within several days in most cases and the recurrence rate is very low. We report the case of a 22-year-old female presented with SPM diagnosed by chest x-ray and chest CT scan who was treated conservatively with subsequent spontaneous resolution.
自发性纵隔气肿（SPM）在年轻成年人中并不常见，通常无任何合并症或潜在病理状况。其最常见的原因是在诸如潜在哮喘、气压伤、瓦尔萨尔瓦动作或食管破裂等诱发事件的情况下肺泡破裂。患者的表现各异，从胸痛、呼吸困难和吞咽困难到焦虑、虚弱或面部及颈部肿胀。大多数患者检查时有皮下气肿，实验室检查结果可能异常，如C反应蛋白升高和白细胞增多。使用的诊断方法包括胸部X线、CT扫描、超声以及吞钡或食管造影。大多数患者采用休息、镇痛和吸氧等保守治疗。SPM的预后通常良好，大多数情况下数天内即可缓解，复发率很低。我们报告一例22岁女性，通过胸部X线和胸部CT扫描诊断为SPM，经保守治疗后自行缓解。
