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.
Predisposing factors of pneumomediastinum[1]:
- Asthma exacerbation
- COPD
- Interstitial lung disease
- Cystic fibrosis
- Boerhaave syndrome
- Intestinal purforation
- Use of breathing machines
- Excess coughing, sneezing, vomiting
- Direct trauma to the chest, neck or abdomen
Iatrogenic causes include:
- endoscopic procedures[2].
- Intubation/extubation
- central vascular access procedure
- pleural cavity instrumentation
- Chest or abdominal surgery
- Tracheostomy
Pneumomediastinum has also been associated with:
- Mycoplasma pneumonia[3]
- Tuberculosis
- Mediastinitis
- Anorexia[4]
- Obesity
- Dermatomyocitis
- Connective tissue diseases
- Pneumomediastinum may be caused by a pulmonary barotrauma resulting when a person moves to or from a higher pressure environment, such as when a scuba diver[5], a free-diver[6] or an airplane passenger[7] ascends or descends.
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 such as endoscopies, intubation/extubation, surgical intervention such as thyroidectomy, tracheostomy. |
Infectious Disease | Tuberculosis, mycoplasma pneumonia, influenza pneumonia, measels. |
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 | Asthma, Pulmonary barotrauma, COPD, atelectasis, bronchiolitis. |
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. |
References
- ↑ Cheng, Guang-Shing; Varghese, Thomas K.; Park, David R. (2016). "Pneumomediastinum and Mediastinitis": 1496–1510.e12. doi:10.1016/B978-1-4557-3383-5.00084-1.
- ↑ 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.
- ↑ Vázquez JL, Vázquez I, González ML, García-Tejedor JL, Repáraz A (2007). "Pneumomediastinum and pneumothorax as presenting signs in severe Mycoplasma pneumoniae pneumonia". doi:10.1007/s00247-007-0611-1. PMID 17899058.
- ↑ Hatzitolios A, Ntaios G (2007). "Spontaneous Pneumomediastinum May Be Associated with Both Anorexia Nervosa and Obesity". doi:10.1007/s00408-007-9037-7. PMID 17909893.
- ↑ 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
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