Pneumomediastinum
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| Pneumomediastinum Classification and external resources | |
| Pneumomediastinum: Spinnaker sail sign. (Image courtesy of RadsWiki) | |
| ICD-10 | J98.2, P25.2 |
| ICD-9 | 518.1, 770.2 |
| DiseasesDB | 29460 |
| MedlinePlus | 000084 |
| eMedicine | ped/1832 emerg/469 |
| MeSH | D008478 |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Phone:617-632-7753
Associate Editor In Chief: Cafer Zorkun, M.D., Ph.D. [2]
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Overview
Pneumomediastinum (from Greek pneuma - "air", also known as mediastinal emphysema) is a condition in which air is present in the mediastinum.
First described in 1819 by René Laennec,[1][2] the condition can result from physical trauma or other situations that lead to high pressure within the alveoli of the lung, causing them to burst and leak air into the chest cavity.
Differential diagnosis of causes of pneumomediastinum
It is most commonly caused by:
- Oesophageal rupture, for example in Boerhaave syndrome
- Asthma or other conditions leading to alveolar rupture
It has also been associated with:
It can be induced to assist thoracoscopic surgery.[5]
It can be caused by a pulmonary barotrauma resulting when a person moves to or from a higher pressure environment, such as when a Scuba diver[6][7], a free-diver[8] or an airplane passenger[9] ascends or descends.
Clinical Presentation & Diagnosis
Pneumomediastinum is uncommon, it occurs when air leaks from any part of the lung or airways into the mediastinum and is often recognized on auscultation by a "crunching" sound timed with the cardiac cycle (Hamman's crunch). Subcutaneous emphysema is one of the symptoms of pneumomediastinum.
The diagnosis can be confirmed via chest X-ray showing a radiolucent outline around the heart and mediastinum or via CT scanning of the thorax.
Chest X Ray
Computerized Tomography
Images shown below are courtesy of RadsWiki.
References
- ↑ Laënnec RTH. De l’auscultation médiate ou Traité du Diagnostic des Maladies des Poumon et du Coeur. 1st ed. Paris: Brosson & Chaudé; 1819.
- ↑ Roguin A (2006). "Rene Theophile Hyacinthe Laënnec (1781-1826): the man behind the stethoscope". Clinical medicine & research 4 (3): 230–5. PMID 17048358.
- ↑ 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.
- ↑ 4.0 4.1 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.
- ↑ 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. Retrieved on 2008-06-05.
- ↑ Dr. Richard Moon, Diver's Alert Network Vice President and Medical Director, http://www.diversalertnetwork.org/medical/articles/article.asp?articleid=40
- ↑ Jacobson FL, Loring SH, Ferrigno M (2006). "Pneumomediastinum after lung packing". Undersea Hyperb Med 33 (5): 313–6. PMID 17091828. Retrieved on 2008-06-05.
- ↑ Nicol E, Davies G, Jayakumar P, Green ND (April 2007). "Pneumopericardium and pneumomediastinum in a passenger on a commercial flight". Aviat Space Environ Med 78 (4): 435–9. PMID 17484349. Retrieved on 2008-06-05.
External links
Acknowledgements
The content on this page was first contributed by: C. Michael Gibson M.S., M.D.
WikiDoc Research Resources for Pneumomediastinum | |
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| Articles on Pneumomediastinum | Most recent articles on Pneumomediastinum • Most cited articles on Pneumomediastinum • Review articles on Pneumomediastinum • Articles on Pneumomediastinum in N Eng J Med, Lancet, BMJ |
| Media (Slides, Video, Images, MP3) on Pneumomediastinum | Powerpoint slides on Pneumomediastinum • Images of Pneumomediastinum • Photos of Pneumomediastinum • Podcasts & MP3s on Pneumomediastinum • Videos on Pneumomediastinum |
| Evidence Based Medicine Regarding Pneumomediastinum | Cochrane Collaboration on Pneumomediastinum • Bandolier on Pneumomediastinum • TRIP on Pneumomediastinum |
| Cost Effectiveness of Pneumomediastinum | Cost Effectiveness of Pneumomediastinum |
| Clinical Trials Involving Pneumomediastinum | Ongoing Trials on Pneumomediastinum at Clinical Trials.gov • Trial results on Pneumomediastinum • Clinical Trials on Pneumomediastinum at Google |
| Guidelines / Policies / Government Resources (FDA/CDC) Regarding Pneumomediastinum | US National Guidelines Clearinghouse on Pneumomediastinum • NICE Guidance on Pneumomediastinum • NHS PRODIGY Guidance • FDA on Pneumomediastinum • CDC on Pneumomediastinum |
| Textbook Information on Pneumomediastinum | Books and Textbook Information on Pneumomediastinum |
| Pharmacology Resources on Pneumomediastinum | Dosing of Pneumomediastinum • Drug interactions with Pneumomediastinum • Side effects of Pneumomediastinum • Allergic reactions to Pneumomediastinum • Overdose information on Pneumomediastinum • Carcinogenicity information on Pneumomediastinum • Pneumomediastinum in pregnancy • Pharmacokinetics of Pneumomediastinum • |
| Genetics, Pharmacogenomics, and Proteinomics of Pneumomediastinum | Genetics of Pneumomediastinum • Pharmacogenomics of Pneumomediastinum • Proteomics of Pneumomediastinum |
| Newstories on Pneumomediastinum | Pneumomediastinum in the news • Be alerted to news on Pneumomediastinum • News trends on Pneumomediastinum |
| Commentary on Pneumomediastinum | Blogs on Pneumomediastinum |
| Patient Resources on Pneumomediastinum | Patient resources on Pneumomediastinum • Discussion groups on Pneumomediastinum • Patient Handouts on Pneumomediastinum • Directions to Hospitals Treating Pneumomediastinum • Risk calculators and risk factors for Pneumomediastinum |
| Healthcare Provider Resources on Pneumomediastinum | Symptoms of Pneumomediastinum • Causes & Risk Factors for Pneumomediastinum • Diagnostic studies for Pneumomediastinum • Treatment of Pneumomediastinum |
| Continuing Medical Education (CME) Programs on Pneumomediastinum | CME Programs on Pneumomediastinum |
| International Resources on Pneumomediastinum | Pneumomediastinum en Espanol • Pneumomediastinum en Francais |
| Business Resources on Pneumomediastinum | Pneumomediastinum in the Marketplace • Patents on Pneumomediastinum |
| Informatics Resources on Pneumomediastinum | List of terms related to Pneumomediastinum |
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Acknowledgement and Attribution Regarding Sources of Content
Some of the initial content on this page may be incorporated in part from copyleft sources in the public domain including wikis such as Wikipedia and AskDrWiki. Drug information for patients came from the The National Library of Medicine. Infectious disease information may have come from the Centers for Disease Control (CDC). Differential Diagnoses are drawn from clinicians as well as an amalgamation of 3 sources: 1.The Disease Database; 2. Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:3; 3. Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:7 .

