Overby K J, Litt I F
Department of Pediatrics, Stanford University School of Medicine, California.
Pediatrics. 1988 Jan;81(1):134-6.
A case of asymptomatic pneumomediastinum in a 14-year-old girl with anorexia nervosa and self-induced emesis is reported to emphasize the atypical aspects of this case and the importance of differentiating benign from potentially life-threatening sources of mediastinal air. Individuals who engage in purging behavior are not only at increased risk for both alveolar (primary pneumomediastinum) and esophageal perforation (Boerhaave syndrome) but may also obscure or delay the diagnosis by denying symptoms and/or previous emesis. Because esophageal perforation is serious, the presence of free mediastinal air in a patient with a known or suspected history of emesis should provoke prompt radiographic evaluation of the upper gastrointestinal tract.
报告了一例14岁神经性厌食症且有自我催吐行为的女孩发生无症状纵隔气肿的病例，以强调该病例的非典型特征以及区分良性与潜在危及生命的纵隔积气来源的重要性。进行清除行为的个体不仅肺泡（原发性纵隔气肿）和食管穿孔（Boerhaave综合征）风险增加，还可能通过否认症状和/或既往呕吐史而掩盖或延迟诊断。由于食管穿孔很严重，有已知或疑似呕吐史的患者出现纵隔游离气体应促使对上消化道进行及时的影像学评估。
