General

Spontaneous Pneumomediastinum, Is it very rare??

Created by:

 
3 Jul 2016 - General
 

Pneumomediastinum (Mediastinal emphysema) is a consequence of air leakage from the bronchial tree or lungs into the mediatinal structures, with possible upward extension into the neck. While traumatic chest or oesophageal injuries are the well-known causes of secondary pneumomediastinum, the first case of spontaneous pneumomediastinum(also known as Hamman's Syndrome) was described only in 1939 by Louis Hamman. It is considered rare, with approximate frequencies of 1 per 10,000 admissions (or fewer) reported. Clinical features of spontaneous pneumomediastinum include chest pain, dyspnoea, dysphagia, neck pain, subcutaneous emphysem, and Hamman's crunch. It usually will follow a benign self limitng course. It is vital to exclude the secondary/traumatic cause of pneumomediastinum. 

Anyone came across any case of spontaneous pneumomediastinum ?? Personally I have 2 encounters so far.

2nd case was middle age male, was admitted due to 4 days history of dry cough, feverish, rigor , general unwell and was found to have surgical emphysema at the right side of his neck by GP. Examination showed bronchial breath sound at right upper lobe, and subcutaneous crepitations noticed over right side of neck. Chest x-ray on admission showed opacities around both upper zones and right sided surgical emphysema at the base of neck, suspicious of pneumomediastiinum. CT-Thorax showed pneumomed...
 (Total 111 words)
Hi Marinelle, I have encountered only 2 cases so far for the last 6 years. The first case was a elderly patient , with background history of pulmonary fibrosis, presented with 2 weeks history of productive cough and fever. Initially examination showed that he had low grade pyrexia and coarse crepitations bi-basally. Chest X-Ray on admission showed pneumonic consolidation. He was treated for pneumonia. Tamiflu was added because his H1N1 swab was positive on day 5 of admission. Over next 5 day...
 (Total 126 words)
During my 2 years of medical practice (Plus 5 years of undergraduate clinical training) I have not encountered a single case of spontaneous pneumomediastinum. The occurrence of spontaneous pneumomediastinum is rare, but the less number of incidents recorded could also be partly due to the fact that this condition is often underdiagnosed by doctors. Sometimes the level of exposure and clarity are not satisfactory in plain radiographs (this is a major problem in government hospitals with outdated...
 (Total 108 words)