Pneumomediastinum classification

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; 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: Predisposing factors are preexisting medical conditions such as asthma, interstitial lung disease, COPD, bronchiectasis, lung cysts, lung malignancy, excessive vomiting.
  • Another cause of sponateous pneumomediastinum is use of tobacco and recreational drugs such as cocaine, marijuana, methamphetamine.
• Secondary pneumomediastinum:
  • Iatrogenic: Endoscopic procedures, intubation/extubation, central line placement.
  • Traumatic: Blunt force trauma, penetrating injury.

Pneumomediastinum

Spontaneous pneumomediastinum Asthma ILD COPD Bronchiectasis Lung cyst Lung cancer Excessive emesis Tobacco use Recreational drug use

Secondary pneumomediastinum

Iatrogenic

Traumatic

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