Irwin Trent, Rishi Mohit, Upadhyay Bishwas
Department of Internal Medicine, University of Nevada, Reno School of Medicine, Reno, NV, USA.
Respir Med Case Rep. 2017 Sep 6;22:228-231. doi: 10.1016/j.rmcr.2017.09.001. eCollection 2017.
To present a case of asymptomatic spontaneous pneumomediastinum and review available evidence-based workup and management.
A young Caucasian adult male with a history of inhalational drug use was admitted to the internal medicine service for evaluation of dehydration and mild rhabdomyolysis. Patient had been on the run from the police and had spent the last days prior to presentation without food, water, or shelter. On admission, patient had no complaints, except for thirst. It was detected on physical exam and chest x-ray that patient had subcutaneous emphysema and pneumomediastinum. The patient was treated conservatively and discharged after a period of observation.
Spontaneous pneumomediastinum is benign and seen primarily in young adults. It is more commonly associated with symptoms like chest pain and/or dyspnea, making an asymptomatic case particularly distinctive. The etiologies and precipitating factors are varied and often an apparent cause isn't identified. The diagnostic approach involves chest x-ray and/or computed tomography (CT) chest with further workup being largely unnecessary. The tenants of management include bedrest, analgesics, and supplemental oxygen as needed.
报告一例无症状自发性纵隔气肿病例，并回顾现有的循证检查及处理方法。
一名有吸入性药物使用史的年轻白人成年男性因脱水和轻度横纹肌溶解症入住内科进行评估。该患者一直在躲避警方，在就诊前的最后几天没有食物、水和住所。入院时，患者除口渴外无其他不适。体格检查和胸部X线检查发现患者有皮下气肿和纵隔气肿。患者接受了保守治疗，并在观察一段时间后出院。
自发性纵隔气肿是良性的，主要见于年轻人。它更常与胸痛和/或呼吸困难等症状相关，因此无症状病例尤为独特。其病因和诱发因素多种多样，通常无法确定明显的病因。诊断方法包括胸部X线检查和/或胸部计算机断层扫描（CT），大多无需进一步检查。处理原则包括卧床休息、使用镇痛药以及按需补充氧气。
