Pneumomediastinum causes
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Trusha Tank, M.D.[2], Jacquelyne DiTroia
Overview
Spontaneous pneumomediastinum may be caused without any underlying pathology. Secondary pneumomediastinum may be caused by blunt or penetrating trauma to the neck, chest or abdomen. Iatrogenic causes include disruption of the airways or GI tract during endoscopic procedures, intubation/extubation, central vascular access procedure, pleural cavity instrumentation, chest or abdominal surgery. Pneumomediastinum has also been associated with: Mycoplasma pneumonia, anorexia, obesity and pulmonary barotrauma in scuba diver or an airplane passenger during rapid ascends or descends.
Causes
Spontaneous pneumomediastinum may be caused without any underlying pathology in an apparently healthy individual.
Common Causes
Common causes of pneumomediastinum are Iatrogenic and include:[1]
- Endoscopic procedures
- Intubation/extubation
- Central vascular access procedure
- Pleural cavity instrumentation
- Chest or abdominal surgery
- Tracheostomy
Less Common Causes
Less common cause of pneumomediastinum is pulmonary barotrauma resulting when a person moves to or from a higher pressure environment, including:
Causes by Organ System
| Cardiovascular | No underlying causes |
| Chemical / poisoning | Inhalation of varnish fumes. |
| Dermatologic | No underlying causes |
| Drug Side Effect | Amiodarone-induced pulmonary toxicity |
| Ear Nose Throat | Esophageal perforation, Oesophageal rupture, Boerhaave syndrome |
| Endocrine | No underlying causes |
| Environmental | No underlying causes |
| Gastroenterologic | No underlying causes |
| Genetic | No underlying causes |
| Hematologic | No underlying causes |
| Iatrogenic | Interventions in the tracheobronchial tree or GI tract, endoscopies, intubation/extubation, thyroidectomy, tracheostomy. |
| Infectious Disease | No underlying causes |
| Musculoskeletal / Ortho | Dermatomyoscitis. |
| Neurologic | No underlying causes |
| Nutritional / Metabolic | No underlying causes |
| Obstetric/Gynecologic | No underlying causes |
| Oncologic | No underlying causes |
| Opthalmologic | No underlying causes |
| Overdose / Toxicity | No underlying causes |
| Psychiatric | No underlying causes |
| Pulmonary | No underlying causes |
| Renal / Electrolyte | No underlying causes |
| Rheum / Immune / Allergy | No underlying causes |
| Sexual | No underlying causes |
| Trauma | Blunt or penetrating truma to the chest or abdomen. |
| Urologic | No underlying causes |
| Dental | Tooth extraction |
| Miscellaneous | Anorexia, obesity breathing machines, ascend/descend injury during deep sea diving |
Causes in Alphabetical Order
- Airplane passenger
- Amiodarone-induced pulmonary toxicity
- Central vascular access procedure
- Chest or abdominal surgery
- Endoscopic procedures
- Free diver
- Intubation/extubation
- Pleural cavity instrumentation
- Scuba diver
- Tooth extraction
- Tracheostomy
References
- ↑ Utsumi T, Shiono H, Fukai I, Akashi A (2007). "Artificial pneumomediastinum facilitates thoracoscopic surgery in anterior mediastinum". Interactive cardiovascular and thoracic surgery. 6 (3): 411–2. doi:10.1510/icvts.2006.147355. PMID 17669882.
- ↑ Tetzlaff K, Reuter M (1998). "Recurrent pulmonary barotrauma (PBT) in a previously healthy male scuba diver who suffered from repeated pneumomediastinum after shallow-water scuba dives". Undersea Hyperb Med. 25 (2): 127–8. PMID 9670439.
- ↑ Jacobson FL, Loring SH, Ferrigno M (2006). "Pneumomediastinum after lung packing". Undersea Hyperb Med. 33 (5): 313–6. PMID 17091828. Retrieved 2008-06-05.
- ↑ Nicol E, Davies G, Jayakumar P, Green ND (2007). "Pneumopericardium and pneumomediastinum in a passenger on a commercial flight". Aviat Space Environ Med. 78 (4): 435–9. PMID 17484349. Retrieved 2008-06-05. Unknown parameter
|month=ignored (help) - ↑ Leonard, A.; Corris, P.; Parums, D.; Donaldson, L; Grant, I S; Naysmith, M R; Thomas, J S. J; Jessurun, G. A J (1997). "Amiodarone pulmonary toxicity". BMJ. 314 (7097): 1831–1831. doi:10.1136/bmj.314.7097.1831b. ISSN 0959-8138.