Pneumomediastinum history and symptoms: Difference between revisions
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{{Pneumomediastinum}} | {{Pneumomediastinum}} | ||
{{CMG}}{{AE}} {{Trusha}} Jacquelyne DiTroia | {{CMG}}{{AE}} {{Trusha}}, Jacquelyne DiTroia | ||
==Overview== | ==Overview== | ||
Most common symptoms seen in pneumomediastinum are sudden onset of pain in the chest and [[subcutaneous emphysema]]. In most cases, pain follows the signs of causative or underlying pathology such as [[Asthma exacerbation resident survival guide|exacerbation of asthma]]. Spontaneous pneumomediastinum in most cases presents without any symptoms. Besides chest pain, other frequent symptoms are cough, [[dyspnea]] or pain in the neck. Most specific finding on physical exam is [[Hamman's sign]], which is a mediastinal crunch or click present on auscultation over the [[cardiac apex]] and the [[left sternal border]] synchronous with the heartbeat. | |||
==History and Symptoms== | ==History and Symptoms== | ||
* | === History === | ||
* | There are several causative and/or precipitating factors associated with pneumomediastinum. Specific history should be focused on:<ref name="pmid25388364">{{cite journal |vauthors=Agut A, Talavera J, Buendia A, Anson A, Santarelli G, Gomez S |title=IMAGING DIAGNOSIS-SPONTANEOUS PNEUMOMEDIASTINUM SECONDARY TO PRIMARY PULMONARY PATHOLOGY IN A DALMATIAN DOG |journal=Vet Radiol Ultrasound |volume=56 |issue=5 |pages=E54–7 |date=2015 |pmid=25388364 |doi=10.1111/vru.12223 |url=}}</ref><ref name="pmid15997870">{{cite journal |vauthors=Chiu CY, Wong KS, Yao TC, Huang JL |title=Asthmatic versus non-asthmatic spontaneous pneumomediastinum in children |journal=Asian Pac. J. Allergy Immunol. |volume=23 |issue=1 |pages=19–22 |date=March 2005 |pmid=15997870 |doi= |url=}}</ref><ref name="pmid19411438">{{cite journal |vauthors=Iyer VN, Joshi AY, Ryu JH |title=Spontaneous pneumomediastinum: analysis of 62 consecutive adult patients |journal=Mayo Clin. Proc. |volume=84 |issue=5 |pages=417–21 |date=May 2009 |pmid=19411438 |pmc=2676124 |doi=10.1016/S0025-6196(11)60560-0 |url=}}</ref> | ||
* | * [[Asthma history and symptoms|Asthma]] | ||
* [[Chronic obstructive pulmonary disease history and symptoms|COPD]] | |||
* [[Pneumonia history and symptoms|Pneumonia]] | |||
* [[Acute respiratory distress syndrome history and symptoms|ARDS]] | |||
* [[Interstitial lung disease]] | |||
* [[Mediastinitis history and symptoms|Mediastinitis]] | |||
* Procedures | |||
** [[Endoscopy]] | |||
=== Symptoms === | |||
The clinical presentation of pneumomediastinum depends on the causative or precipitating factor. Common symptoms of pneumomediastinum include:<ref>name="pmid18721592">{{cite journal |vauthors=Caceres M, Ali SZ, Braud R, Weiman D, Garrett HE |title=Spontaneous pneumomediastinum: a comparative study and review of the literature |journal=Ann. Thorac. Surg. |volume=86 |issue=3 |pages=962–6 |date=September 2008 |pmid=18721592 |doi=10.1016/j.athoracsur.2008.04.067 |url=}}</ref><ref>{{cite journal |vauthors=Nakagawa, Hideki, Yamauchi, Miwa, Kusuyama, Toshiyuki, Fukuda, Hiroyuki, & Ogawa, Kaoru |date= |title=Cervical emphysema secondary to pneumomediastinum as a complication of childbirth |url= |journal=Ear, Nose and Throat Journal |volume= 82(12)|issue= |pages=948-51 |doi= |pmc= |pmid= |access-date=Dec, 2003 }}</ref><ref name="RiccioAbbott1990">{{cite journal|last1=Riccio|first1=John C.|last2=Abbott|first2=Jean|title=A simple sore throat?: Retropharyngeal emphysema secondary to free-basing cocaine|journal=The Journal of Emergency Medicine|volume=8|issue=6|year=1990|pages=709–712|issn=07364679|doi=10.1016/0736-4679(90)90283-2}}</ref><ref name="AbbasAkinkuotu2015">{{cite journal|last1=Abbas|first1=Paulette I.|last2=Akinkuotu|first2=Adesola C.|last3=Peterson|first3=Michelle L.|last4=Mazziotti|first4=Mark V.|title=Spontaneous pneumomediastinum in the pediatric patient|journal=The American Journal of Surgery|volume=210|issue=6|year=2015|pages=1031–1036|issn=00029610|doi=10.1016/j.amjsurg.2015.08.002}}</ref><ref name="Andrade SemedoSilva2012">{{cite journal|last1=Andrade Semedo|first1=Flávia Helena Monteiro|last2=Silva|first2=Rosário Santos|last3=Pereira|first3=Sónia|last4=Alfaiate|first4=Teresa|last5=Costa|first5=Teresa|last6=Fernandez|first6=Pilar|last7=Pereira|first7=Amélia|title=Pneumomediastino espontâneo: relato de um caso|journal=Revista da Associação Médica Brasileira|volume=58|issue=3|year=2012|pages=355–357|issn=01044230|doi=10.1590/S0104-42302012000300017}}</ref> | |||
*Severe, [[Acute chest pain|acute pain in the chest]] ([[pain]] may radiate to the shoulders or back) | |||
*[[Dyspnea|Shortness of breath]] | |||
*[[Fever]] | |||
*[[Neck pain|Cervical pain]] ([[Subcutaneous emphysema]]) | |||
*[[Jaw pain]] ([[Subcutaneous emphysema]]) | |||
*[[Swelling of neck or neck glands|Swelling of neck]], [[Swollen face|face]], [[chest]], [[abdomen]], [[shoulder]] ([[subcutaneous emphysema]]) | |||
*[[Dysphonia]] | |||
*[[Dysphagia]] | |||
*[[Nausea and vomiting|Emesis]] | |||
==References== | ==References== | ||
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[[Category:Emergency medicine]] | [[Category:Emergency medicine]] | ||
[[Category:Cardiology]] | [[Category:Cardiology]] | ||
[[Category:Medicine]] | |||
[[Category:Surgery]] | |||
{{WH}} | {{WH}} | ||
{{WS}} | {{WS}} | ||
Latest revision as of 14:59, 11 February 2019
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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
Most common symptoms seen in pneumomediastinum are sudden onset of pain in the chest and subcutaneous emphysema. In most cases, pain follows the signs of causative or underlying pathology such as exacerbation of asthma. Spontaneous pneumomediastinum in most cases presents without any symptoms. Besides chest pain, other frequent symptoms are cough, dyspnea or pain in the neck. Most specific finding on physical exam is Hamman's sign, which is a mediastinal crunch or click present on auscultation over the cardiac apex and the left sternal border synchronous with the heartbeat.
History and Symptoms
History
There are several causative and/or precipitating factors associated with pneumomediastinum. Specific history should be focused on:[1][2][3]
Symptoms
The clinical presentation of pneumomediastinum depends on the causative or precipitating factor. Common symptoms of pneumomediastinum include:[4][5][6][7][8]
- Severe, acute pain in the chest (pain may radiate to the shoulders or back)
- Shortness of breath
- Fever
- Cervical pain (Subcutaneous emphysema)
- Jaw pain (Subcutaneous emphysema)
- Swelling of neck, face, chest, abdomen, shoulder (subcutaneous emphysema)
- Dysphonia
- Dysphagia
- Emesis
References
- ↑ Agut A, Talavera J, Buendia A, Anson A, Santarelli G, Gomez S (2015). "IMAGING DIAGNOSIS-SPONTANEOUS PNEUMOMEDIASTINUM SECONDARY TO PRIMARY PULMONARY PATHOLOGY IN A DALMATIAN DOG". Vet Radiol Ultrasound. 56 (5): E54–7. doi:10.1111/vru.12223. PMID 25388364.
- ↑ Chiu CY, Wong KS, Yao TC, Huang JL (March 2005). "Asthmatic versus non-asthmatic spontaneous pneumomediastinum in children". Asian Pac. J. Allergy Immunol. 23 (1): 19–22. PMID 15997870.
- ↑ Iyer VN, Joshi AY, Ryu JH (May 2009). "Spontaneous pneumomediastinum: analysis of 62 consecutive adult patients". Mayo Clin. Proc. 84 (5): 417–21. doi:10.1016/S0025-6196(11)60560-0. PMC 2676124. PMID 19411438.
- ↑ name="pmid18721592">Caceres M, Ali SZ, Braud R, Weiman D, Garrett HE (September 2008). "Spontaneous pneumomediastinum: a comparative study and review of the literature". Ann. Thorac. Surg. 86 (3): 962–6. doi:10.1016/j.athoracsur.2008.04.067. PMID 18721592.
- ↑ Nakagawa, Hideki, Yamauchi, Miwa, Kusuyama, Toshiyuki, Fukuda, Hiroyuki, & Ogawa, Kaoru. "Cervical emphysema secondary to pneumomediastinum as a complication of childbirth". Ear, Nose and Throat Journal. 82(12): 948–51. Vancouver style error: initials (help); Check date values in:
|access-date=(help);|access-date=requires|url=(help) - ↑ Riccio, John C.; Abbott, Jean (1990). "A simple sore throat?: Retropharyngeal emphysema secondary to free-basing cocaine". The Journal of Emergency Medicine. 8 (6): 709–712. doi:10.1016/0736-4679(90)90283-2. ISSN 0736-4679.
- ↑ Abbas, Paulette I.; Akinkuotu, Adesola C.; Peterson, Michelle L.; Mazziotti, Mark V. (2015). "Spontaneous pneumomediastinum in the pediatric patient". The American Journal of Surgery. 210 (6): 1031–1036. doi:10.1016/j.amjsurg.2015.08.002. ISSN 0002-9610.
- ↑ Andrade Semedo, Flávia Helena Monteiro; Silva, Rosário Santos; Pereira, Sónia; Alfaiate, Teresa; Costa, Teresa; Fernandez, Pilar; Pereira, Amélia (2012). "Pneumomediastino espontâneo: relato de um caso". Revista da Associação Médica Brasileira. 58 (3): 355–357. doi:10.1590/S0104-42302012000300017. ISSN 0104-4230.