Journal of Chest Surgery

The Korean Society for Thoracic and Cardiovascular Surgery (대한심장혈관흉부외과학회)
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Clinical Manifestations of Spontaneous Pneumomediastinum

  • Park, Soo Jin (Department of Thoracic and Cardiovascular Surgery, Ajou University School of Medicine) ;
  • Park, Ji Ye (Department of Thoracic and Cardiovascular Surgery, Ajou University School of Medicine) ;
  • Jung, Joonho (Department of Thoracic and Cardiovascular Surgery, Ajou University School of Medicine) ;
  • Park, Seong Yong (Department of Thoracic and Cardiovascular Surgery, Ajou University School of Medicine)
  • Received : 2015.08.19
  • Accepted : 2015.09.30
  • Published : 2016.08.05
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Abstract

Background: Spontaneous pneumomediastinum (SPM) is an uncommon disorder with only a few reported clinical studies. The goals of this study were to investigate the clinical manifestations and the natural course of S PM, as w ell as examine the current available treatment options for SPM. Methods: We retrospectively reviewed 91 patients diagnosed with SPM between January 2008 and June 2015. Results: The mean age of the patients was $22.7{\pm}13.2years$, and 67 (73.6%) were male. Chest pain (58, 37.2%) was the predominant symptom. The most frequent precipitating factor before developing SPM was a cough (15.4%), but the majority of patients (51, 56.0%) had no precipitating factors. Chest X-ray was diagnostic in 44 patients (48.4%), and chest computed tomography (CT) showed mediastinal air in all cases. Esophagography (10, 11.0%), esophagoduodenoscopy (1, 1.1%), and bronchoscopy (5, 5.5%) were performed selectively due to clinical suspicion, but no abnormal findings that implicated organ injury were documented. Twelve patients (13.2%) were discharged after a visit to the emergency room, and the others were admitted and received conservative treatment. The mean length of hospital stay was $3.0{\pm}1.6days$. There were no complications related to SPM except for recurrence in 2 patients (2.2%). Conclusion: SPM responds well to conservative treatment and follows a benign natural course. Hospitalization and aggressive treatment can be performed in selective cases.

Keywords

References

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