Pneumomediastinum classification

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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]

Overview

Pneumomediastinum may be classified according to cause into spontaneous pneumomediastinum and secondary pneumomediastinum. Both the categories have multiple causes.

Classification

Pneumomediastinum is mainly classified according to the cause into 2 groups:

• Spontaneous, also known as idiopathic pneumomediastinum: Cause of sponateous pneumomediastinum is use of tobacco and recreational drugs such as cocaine, marijuana, methamphetamine.
• Secondary pneumomediastinum:
  • Iatrogenic: Endoscopic procedures, intubation/extubation, central vascular access procedure, pleural cavity instrumentation, chest or abdominal surgery.
  • Traumatic: Blunt force trauma, penetrating chest or abdominal injury.
  • Non-traumatic: Predisposing factors are preexisting medical conditions such as asthma, interstitial lung disease, COPD, bronchiectasis, lung cysts, lung malignancy, excessive vomiting.

Pneumomediastinum

Spontaneous pneumomediastinum •Tobacco and recreational drug use

Secondary pneumomediastinum

Iatrogenic • Endoscopic procedures • Intubation/extubation • Central line access • Pleural cavity instrumentation • Chest or abdominal surgery

Traumatic • Blunt force trauma • Penetrating truma to chest/abdomen Non traumatic • Asthma • Interstitial lung disease • COPD • Bronchiectasis • Lung cysts • Lung malignacies • Excessive vomitting

• Pneumomediastinum can also be classified according to the entry of air into the mediastinal cavity: Head/neck/upper respiratory tract, lower respiratory tract, lungs, gastrointestinal tract, or external environment.