Wengse Carl, Bolinder Gustav, Aman Emil
Danderyds Sjukhus AB - Medicinkliniken Stockholm, Sweden - Stockholm, Sweden.
Röntgenkliniken - Danderyds sjukhus Stockholm, Sweden Röntgenkliniken - Danderyds sjukhus Stockholm, Sweden.
Lakartidningen. 2018 Jan 9;115:ETD4.
A previously healthy 21-year old man presented to the emergency department with sudden onset central chest pain exacerbated by breathing. A plain chest X-ray showed air within the mediastinum and pericardium confirmed by a CT scan with contrast. The patient history did not raise suspicion of any concomitant disease and the diagnosis of spontaneous pneumomediastinum with pneumopericardium was made. The patient recovered completely over the next few days with bed rest and analgesics. Spontaneous pneumomediastinum is an uncommon disease caused by rupture of perivascular alveoli causing air leakage to the mediastinum. The condition is benign and self-resolving in most cases. Pneumopericardium, a rare complication to spontaneous pneumomediastinum, is also usually self-resolving but may cause cardiac tamponade requiring intervention. Spontaneous pneumomediastinum must be differentiated from secondary pneumomediastinum caused by an underlying condition, such as esofageal rupture, trauma or infection, which may require specific treatment.
一名此前健康的21岁男性因突发中央胸痛且呼吸时加重而就诊于急诊科。胸部X线平片显示纵隔内有气体，CT增强扫描证实心包内也有气体。患者病史未提示任何伴随疾病，诊断为自发性纵隔气肿合并心包积气。患者在接下来的几天里通过卧床休息和使用镇痛药完全康复。自发性纵隔气肿是一种罕见疾病，由血管周围肺泡破裂导致气体漏入纵隔引起。该病在大多数情况下为良性且可自行缓解。心包积气是自发性纵隔气肿的一种罕见并发症，通常也可自行缓解，但可能导致心脏压塞而需要干预。自发性纵隔气肿必须与由潜在疾病（如食管破裂、外伤或感染）引起的继发性纵隔气肿相鉴别，后者可能需要特殊治疗。
