• Hamman’s syndrome
• spontaneous pneumomediastinum

• Humans
• Mediastinal Emphysema/diagnosis
• Mediastinal Emphysema/etiology
• Mediastinal Emphysema/physiopathology
• Mediastinal Emphysema/therapy
• Male
• Syndrome
• Diagnosis, Differential
• Tomography, X-Ray Computed/methods
• Radiography, Thoracic/methods

• cervical abscess
• descending necrotizing mediastinitis
• parapharyngeal space tumor
• pneumomediastinum (pm)
• spontaneous pneumomediastinum (spm)

• boerhaave syndrome
• hamman’s syndrome
• spontaneous pneumomediastinum (spm)
• subcutaneous emphysema
• vomiting

• chest pain
• mediastinal emphysema
• spontaneous pneumomediastinum
• subcutaneous emphysema
• systematic review

• Hamman’s syndrome
• delivery
• pneumomediastinum
• pregnancy

• computed tomogram
• iatrogenic effect
• pneumomediastinum
• pneumoperitoneum
• spontaneous subcutaneous emphysema

• emergency medicine
• esophageal injury
• pediatric surgery
• pediatrics
• spontaneous pneumomediastinum
• surgery

• Humans
• Child
• Male
• Adolescent
• Young Adult
• Adult
• Female
• Retrospective Studies
• Mediastinal Emphysema/diagnostic imaging
• Mediastinal Emphysema/etiology
• Mediastinal Emphysema/therapy
• Case-Control Studies
• Esophageal Perforation/complications
• Esophageal Perforation/diagnostic imaging
• Tomography, X-Ray Computed

• Boerhaave syndrome
• pneumomediastinum
• subcutaneous emphysema
• vomiting

• barotrauma
• esophagram
• marijuana
• marijuana-associated pneumomediastinum
• pneumomediastinum

• acute airway obstruction
• boerhaave syndrome
• difficult airway management
• spontaneous esophageal perforation
• subcutaneous emphysema

• Causes
• Emphysème sous-cutané
• Pneumomédiastin secondaire
• Pneumomédiastin spontané
• Secondary pneumomediastinum
• Spontaneous pneumomediastinum
• Subcutaneous emphysema
• Traitement
• Treatment

Vomiting-induced pneumomediastinum is often caused by oesophageal perforation or alveolar rupture due to increased pressure. A correct diagnosis is important because both diseases have different treatments and severities. We report the case of a 21-year-old man who presented with chest pain and fever after frequent vomiting and had elevated white blood cell counts on blood tests. There was extensive pneumomediastinum, and the lower oesophagus was swollen and thickened on chest computed tomography. An oesophagram was not possible due to severe nausea and vomiting. Accumulation of free air was found along the peripheral bronchi or the pulmonary vascular sheath in the left lower lobe, which was continuous with the mediastinum. Based on the presence of the Macklin effect, we diagnosed a pneumomediastinum with a high possibility of spontaneous pneumomediastinum. The Macklin effect is a finding that can likely distinguish oesophageal perforation from spontaneous pneumomediastinum.

A tracheostomy tube (TT) is usually taken out in a well-planned and coordinated manner after the underlying condition that necessitated the procedure is resolved. The inadvertent removal or dislodgement of the TT from the stroma is known as accidental extubation or decannulation. This event may prove fatal in a stable patient. Like other respiratory procedures, tracheostomy with the long-term placement of tracheal tube comes with several risks, including scarring of the trachea, pneumothorax, tracheal rupture, and tracheoesophageal fistula. Other complications may include pneumomediastinum (PM) or the escape of air into the surrounding tissue. This may be attributed to several reasons, including mispositioning of the tracheal tube, barotrauma, or tracheal rupture. In some cases, PM presents with free air into cavities such as the thorax, peritoneum, or subcutaneous tissue. Although not fatal, it may require complex treatments such as ventilator management, high-flow oxygen, or, in some cases, surgical intervention. In this article, we describe a rare case of PM and generalized surgical emphysema due to mispositioning of the tracheal tube.

• Homocysteine
• Nitrous oxide
• Pneumomediastinum
• Radiology
• Subacute combined degeneration
• Subcutaneous emphysema
• Vitamin B12 deficiency

• inspiratory dyspnea
• opioid epidemic
• shortness of breath
• spontaneous pneumomediastinum (spm)
• unusal causes of persistent chest pain

Pneumomediastinum and subcutaneous emphysema are mostly detected in non-malignant conditions such as certain infections, thoracic surgeries, and trauma. Although this condition is asymptomatic in most cases, sometimes it could be symptomatic and may even be lethal in some patients.

This letter reports a 9-year-old girl with acute lymphoblastic leukemia (ALL) on chemotherapy who developed pneumothorax with the clinical feature of respiratory distress for that a chest tube was inserted immediately. Following the insertion, pneumomediastinum and pneumopericardium developed in the patient. As the next step, a pericardium window was inserted by an expert heart surgeon. During these procedures, all the evaluations for any bacterial or fungal infection were negative. Unfortunately, the patient expired before any further complementary evaluations and it was not clear that the mentioned situation was a result of chemotherapy or ALL.

Although pneumomediastinum and subcutaneous emphysema are rare in patients with ALL, authors strongly suggest clinicians consider them in any similar patients presenting respiratory signs/symptoms for faster onset of action.

• Acute lymphoblastic leukemia
• Pneumomediastinum
• Pneumopericardium
• Subcutaneous emphysema

Spontaneous pneumomediastinum (SPM) is a rare condition defined by the presence of air in the mediastinum in the absence of traumatic or iatrogenic injury. Although the imaging findings and complications of SARS-CoV-2 infection have been reported many times, there are few reports of the prevalence and outcomes of patients with SPM.

In this paper, we aimed to illustrate the different manifestations, management, and outcome of three cases of SPM in COVID-19 patients and provide an extensive review available literature.

Detailed report of patients' demographics, clinical presentation, management, and outcome of three cases of COVID-19 induced SPM seen in our institution was provided. Additionally, literature search was employed through March 2021 using Pubmed and Google scholar databases where a total of 22 articles consisting of 35 patients were included.

Statistical analysis of the reviewed articles showed that SPM in COVID-19 occurs in patients with a mean age of 55.6 ± 16.7 years. Furthermore, 80% of the 35 patients are males and almost 60% have comorbidities. Intriguingly, SPM in COVID-19 is associated with a 28.5% mortality rate. These findings are consistent with our case series and are different from previous reports of SPM in non-COVID-19 cases where it most commonly occurs in younger individuals and has a self-limiting course with a good outcome.

Therefore, SPM in COVID-19 patients occurs in older patients and is potentially associated with a higher mortality rate. Further studies are necessary to assess its role as a prognostic marker of poor outcome.

• COVID-19
• Prognostic factor
• SARS-CoV-2
• Spontaneous pneumomediastinum

• Cervical emphysema
• incidental
• paraneoplastic encephalitis
• positron emission tomography/computed tomography
• spontaneous pneumomediastinum

Vaping is the process of inhaling an aerosol produced by heating a liquid or wax containing substances such as nicotine, cannabinoids (e.g., tetrahydrocannabinol, cannabidiol), flavoring, and additives (e.g., glycerol, propylene glycol). The presence of air or gas in the mediastinum is pneumomediastinum.

We present a rare case of vaping-induced spontaneous pneumomediastinum. A young 20-year-old female patient with a history of vaping and no past medical history presented with acute chest pain to an emergency room. The urine drug screen was positive for cannabinoids. Imaging studies - chest x-ray and computed tomography of the chest - showed pneumomediastinum. The patient was discharged after a day of observation and counseling to quit vaping.

• cannabinoids
• e-cigarette or vaping use-associated lung injury (evali)
• e-cigarette smoking
• e-smoking
• effects of vaping
• electronic nicotine delivery systems
• electronic nicotine delivery systems (ends)
• flavors
• pneumomediastinum
• spontaneous pneumomediastinum

Vaping or E-cigarettes were created to deliver nicotine-containing aerosol to users with a flavoring agent without agents such as tars, oxidant gases, and carbon monoxide smoke found in traditional tobacco cigarettes. The use of E-cigarettes is steadily increasing in the United States, especially among the young population. Electronic cigarettes seem capable of causing various injury patterns in the lungs, collectively called E-cigarettes or vaping-associated lung injury (EVALI). Spontaneous pneumomediastinum (SPM) is a rare finding in EVALI. Here, we report a case of spontaneous pneumomediastinum secondary to vaping in a young man with no past medical history except for daily vaping and a recent untreated influenza infection.

• Boerhaave’s
• Spontaneous pneumomediastinum
• esophageal perforation

The presence of free air in mediastinum is defined as pneumomediastinum. The incidence is between 1/7000-1/32000. In this study, our aim is to discuss our cases with spontaneous pneumomediastinum (SPM), which has low incidence, in the light of the literature.

The files of 11 cases who were diagnosed with SPM in pulmonary diseases and thoracic surgery department and followed up and treated in thoracic surgery clinic between 2012-2018 were retrospectively analyzed. Patients’ age, sex, etiological factors, diagnosis and treatment methods and hospital stay were evaluated.

Between the years of 2012-2018, 11 cases with SPM who were not related to trauma were detected. Nine (81.8%) of the patients were male; the median age was 38.5 years. Among the predisposing factors that played a role in the formation of SPM, the most common symptom was dyspnea, while the second most common symptom was coughing seizures. The median duration of hospitalization was 3.8 days, and no mortality was observed.

Spontaneous pneumomediastinum is a rare clinical condition, especially in young men. SPM treatment can be conservative or surgical.

• Dyspnea
• pneumomediastinum
• spontaneous

Spontaneous pneumomediastinum is a rare condition characterized by interstitial air within the mediastinum without any obvious causative factors. It is most commonly found in young men, and the clinical presentation is typically associated with chest or neck pain and dyspnea. Objective findings can include subcutaneous emphysema of the neck and chest. Asymptomatic cases are exceedingly rare. In this report, we present the case of a 20-year-old woman who presented with acute psychosis and the incidental imaging finding of pneumomediastinum without any associated clinical signs or symptoms.

• asymptomatic pneumomediastinum
• pneumomediastinum

• healthcare improvement and patient safety
• oesophagus
• pneumomediastinum
• surgery

• penumomediastinum
• covid-19
• thoracic surgery

• Adolescent
• Adult
• Aged
• COVID-19
• Humans
• Incidence
• Mediastinal Emphysema/diagnostic imaging
• Mediastinal Emphysema/epidemiology
• Mediastinal Emphysema/etiology
• Middle Aged
• SARS-CoV-2
• Subcutaneous Emphysema
• Young Adult

• infectious diseases
• pneumomediastinum
• pneumonia (infectious disease)
• respiratory medicine

• COVID-19/complications
• COVID-19/diagnostic imaging
• Humans
• Male
• Mediastinal Emphysema/virology
• Middle Aged
• Pneumothorax/virology
• SARS-CoV-2
• Subcutaneous Emphysema/virology

• acute medicine
• cardiothoracic surgery
• respiratory medicine

Pneumomediastinum is the presence of aberrant air in the mediastinum and is most commonly caused by oesophageal or alveolar rupture. Hyperemesis gravidarum is persistent nausea and vomiting before the 20th week of pregnancy and can increase intra-thoracic pressure, precipitating pneumomediastinum.

A 22-year-old patient presented with hyperemesis gravidarum in the 6th week of pregnancy. During her hospital admission, she developed chest pain, and imaging showed pneumomediastinum. Endoscopy excluded oesophageal perforation, a diagnosis of spontaneous pneumomediastinum was made, and her symptoms improved with conservative management.

This case demonstrates how oesophageal perforation and spontaneous mediastinum can present in similar fashion. Oesophageal perforation has high morbidity and mortality and it is vital to identify it early. It is therefore important that clinicians are aware of pneumomediastinum as a potential complication of hyperemesis gravidarum and exclude oesophageal perforation in these individuals.

•

Pneumomediastinum is a rare complication of Hyperemesis Gravidarum.

• Boerhave syndrome
• Case report
• Hyperemesis gravidarum
• Mediastinal emphysema
• Oesophageal rupture
• Pneumomediastinum

Spontaneous pneumomediastinum is an uncommon diagnosis defined as the presence of free air in the mediastinum without an apparent cause. It is a self-limiting disorder that most often occurs in young males without any apparent precipitating factor or underlying disease process. Its pathophysiology involves the rupture of alveoli with resultant air penetration into the mediastinum. Underlying disease processes, such as asthma, physical trauma, including yelling, contact sports, and Valsalva during labor, have also been reported to cause spontaneous pneumomediastinum. Here, we present the case of an 18-year-old male who presented to us with the chief complaint of cough and the subsequent diagnosis of spontaneous pneumomediastinum.

• pulmonary diseases
• respiratory medicine
• respiratory physiology
• spontaneous pneumomediastinum

Pneumomediastinum is defined as the presence of air in the mediastinum. Trauma to the nearby organs can cause air to escape into surrounding tissues that may manifest clinically as severe chest pain, voice change, or shortness of breath. However, pneumomediastinum can present spontaneously in healthy individuals with no inciting factors in which case the condition is termed spontaneous pneumomediastinum (SPM). Pneumomediastinum can be challenging to manage due to the absence of clear guidelines for the diagnosis and management.

We present the case of a 21-year-old with no previous medical history who presented with chest pain that was aggravated by speech and breath. The pain was of sudden onset preceded by smoking at 2:00 am. The patient was tachycardic, tachypnoeic with crepitation on palpation and a crunch sound (Hamman’s sign) on auscultation. The patient rated the pain as 5/10 on a 11-point numerical pain rating scale, which then evolved to 10/10. The patient did not have fever, loss of consciousness (LOC), diaphoresis, history of trauma, or previous similar presentation. There were no other associated symptoms. A chest X-ray (posteroanterior (PA) and lateral view) showed pneumomediastinum, but laboratory tests results were otherwise normal. The patient was observed in the emergency room overnight. He remained stable, his tachycardia settled, and there was no leukocytosis or desaturation; however, tachypnea was observed. His pain symptoms were treated with analgesia as needed and the patient was discharged home in a stable condition, to be followed on an outpatient basis.

Spontaneous pneumomediastinum can be challenging to manage due to the lack of reliable incidence data as well as the absence of clear management guidelines. Further research will aid in understanding the true incidence of SPM in Saudi Arabia and help in establishing a consensual approach and treatment guidelines to deal with SPM in otherwise healthy individuals. To the best of our knowledge, this is the first case of SPM in a young male reported from a tertiary hospital in Riyadh, Saudi Arabia.

• chest pain
• hamman’s sign
• saudi arabia
• spontaneous pneumomediastinum

Tracheostomy is a common procedure seen in critically ill patients that require long term ventilatory support. As with all airway access procedures, tracheotomy with prolonged tracheal tube placement comes with possible risks such as tracheal scarring, tracheal rupture, pneumothorax, tracheoesophageal fistula among others. Another possible complication, though rare, is escape of free air into the surrounding tissue, as well as pneumomediastinum (PM). This may occur due to various reasons, some of them being tracheal rupture, barotrauma or tracheal tube mispositioning. Pneumomediastinum may present with concurrent free air in other body cavities such as the peritoneum, thorax or subcutaneous tissue. Though often not life-threatening it may require treatment including high flow oxygen, ventilator management or occasionally, surgical intervention. Herein we describe a rare case of PM with communicating pneumoperitoneum and massive subcutaneous emphysema due to tracheal tube mispositioning along with a review of the literature.

• mechanical ventilation
• pneumomediastinum
• pneumoperitoneum
• spontaneous pneumomediastinum
• spontaneous pneumoperitoneum
• subcutaneous emphysema
• tracheal tube
• tracheostomy
• ventilator management

Le pneumomédiastin spontané se définit par la présence d'air au niveau du médiastin en l'absence de cause traumatique ou iatrogène. Son diagnostic repose sur la radiographie thoracique. Le recours à d'autres examens paracliniques, tels que la tomodensitométrie thoracique ou la fibroscopie bronchique ou digestive, s'impose parfois. L'évolution est le plus souvent favorable. Nous rapportons 18 cas de pneumomédiastin spontané, colligés au service des maladies respiratoires du CHU Ibn Rochd de Casablanca entre 2006 et 2017. Il s'agit de 13 hommes et de cinq femmes dont la moyenne d'âge était de 24 ans. La symptomatologie clinique était dominée par la douleur thoracique rétrosternale. Les circonstances de survenue du pneumomédiastin étaient des quintes de toux dans sept cas, une crise d'asthme dans cinq cas, une consommation de narguilé et des vomissements Itératifs dans deux cas chacun, un accouchement et une exacerbation d'origine bactérienne de BPCO dans un cas chacun. L'évolution était favorable dans tous les cas avec une résorption spontanée du pneumomédiastin. Aucune récidive n'est survenue après un recul moyen de 3 ans.

• Pneumomediastinum
• chest pain
• emphysema
• mediastinal disease
• spontaneous

To present an unusual case and proposed mechanism of bilateral spontaneous pneumothoraces with pneumomediastinum in a patient with intravenous methamphetamine use.

Thin white man presented with confusion and chest pain after intravenous methamphetamine use. Initial workup found bilateral pneumothoraces with pneumomediastinum. Conservative management was initiated and subsequent radiographs and physical examination revealed subsequent improvement in pneumothoraces and pneumomediastinum.

Intravenous methamphetamine use increases a wide number of inflammatory markers that can increase the risk of spontaneous pneumothoraces and pneumomediastinum. In patients with known risk factors, methamphetamine use can promote an increased incidence of spontaneous pneumothorax and pneumomediastinum.

• Inflammatory markers
• Methamphetamine use
• Pneumomediastinum
• Pneumothorax

Spontaneous pneumomediastinum is defined as free air or gas contained within the mediastinum, which almost invariably originates from the alveolar space or the conducting airways. It is rare in pediatric patients; however, occasional cases are reported to result from forced Valsalva’s maneuver due to cough, emesis, a first attack of wheeze, or asthma exacerbations. We report the case of a 7-year-old previously healthy girl, with a history of persistent dry cough one day before, who was brought to our unit with face, neck and chest swelling. The chest X-ray and computed tomography (CT) scan showed subcutaneous emphysema with pneumomediastinum and pneumopericardium without evidence of the origin of this air leak. Laboratory tests and the bronchoscopy were normal. The patient was admitted in the pediatric critical care and received noninvasive monitoring, analgesia, oxygen, and omeprazole as a prophylaxis for a gastric ulcer. The patient improved, subcutaneous emphysema resolved, and she was discharged on the third day.

• Valsalva’s maneuver
• emphysema
• pneumomediastinum
• pneumopericardium

Pneumomediastinum is a rare clinical entity that concerns the clinicians in the emergency department. We present a case of a patient with spontaneous pneumomediastinum (Hamman's syndrome) that presented to our hospital's emergency department with cervical subcutaneous emphysema. A conservative treatment with observation was performed. The patient after 24 hours of observation was discharged with a suggested follow-up.

• Dyspnea
• Emphysema
• Hamman's syndrome
• Pneumomediastinum

• Diagnosis
• Pneumomedistinum
• Spontaneous
• Treatment

• Cocaine-Related Disorders/complications
• Humans
• Mediastinal Emphysema/chemically induced
• Mediastinal Emphysema/diagnosis