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==Overview==
==Overview==

Revision as of 15:53, 24 September 2012

Pneumomediastinum
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

Pneumomediastinum Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Pneumomediastinum from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Diagnostic Study of Choice

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiogram

Chest X Ray

CT

MRI

Echocardiography or Ultrasound

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Primary Prevention

Secondary Prevention

Case Studies

Case #1

Pneumomediastinum On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

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American Roentgen Ray Society Images of Pneumomediastinum

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X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Pneumomediastinum

CDC on Pneumomediastinum

Pneumomediastinum in the news

Blogs on Pneumomediastinum

Directions to Hospitals Treating Pneumomediastinum

Risk calculators and risk factors for Pneumomediastinum

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor In Chief: Cafer Zorkun, M.D., Ph.D. [2]

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:

  • 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

  1. Laënnec RTH. De l’auscultation médiate ou Traité du Diagnostic des Maladies des Poumon et du Coeur. 1st ed. Paris: Brosson & Chaudé; 1819.
  2. Roguin A (2006). "Rene Theophile Hyacinthe Laënnec (1781-1826): the man behind the stethoscope". Clinical medicine & research. 4 (3): 230–5. PMID 17048358.
  3. 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. 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.
  5. 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.
  6. 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 2008-06-05.
  7. Dr. Richard Moon, Diver's Alert Network Vice President and Medical Director, http://www.diversalertnetwork.org/medical/articles/article.asp?articleid=40
  8. Jacobson FL, Loring SH, Ferrigno M (2006). "Pneumomediastinum after lung packing". Undersea Hyperb Med. 33 (5): 313–6. PMID 17091828. Retrieved 2008-06-05.
  9. 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 |month= ignored (help)

External links

Acknowledgements

The content on this page was first contributed by: C. Michael Gibson M.S., M.D.


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