Nagamine Takahiko
Psychosomatic Dentistry, Tokyo Medical and Dental University, Tokyo, JPN.
Psychiatric Internal Medicine, Sunlight Brain Research Center, Yamaguchi, JPN.
Cureus. 2024 Jan 8;16(1):e51887. doi: 10.7759/cureus.51887. eCollection 2024 Jan.
A middle-aged female patient with schizophrenia and osteoporosis presented to the emergency department with complaints of sore throat, neck pain, and dysphagia, which was identified as spontaneous pneumomediastinum (SPM) on chest CT. SPM has been reported in anorexia nervosa, but this is the first report of SPM in schizophrenia. In anorexia nervosa, an increase in intrathoracic pressure because of vomiting can cause positive pressure SPM, but this patient was considered to have negative pressure SPM because of decreased mediastinal pressure. In schizophrenia patients with unexplained chest pain, neck pain, and dysphagia, SPM should be considered a differential disease, and a chest CT scan is useful for diagnosis.
一名患有精神分裂症和骨质疏松症的中年女性患者因咽痛、颈部疼痛和吞咽困难前往急诊科就诊,胸部CT检查发现为自发性纵隔气肿(SPM)。神经性厌食症中曾有过SPM的报道,但这是精神分裂症患者中SPM的首例报道。在神经性厌食症中,呕吐导致的胸内压升高可引起正压性SPM,但该患者因纵隔压力降低被认为患有负压性SPM。对于有不明原因胸痛、颈部疼痛和吞咽困难的精神分裂症患者,应考虑SPM为鉴别诊断疾病,胸部CT扫描有助于诊断。