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Vol. 24 - Num. 93

Original Papers

Pneumomediastinum in pediatrics: experience in a tertiary hospital

Patricia Fernández Garcíaa, Cristina González Menchéna, José Tomás Ramos Amadora

aServicio de Pediatría. Hospital Universitario Clínico San Carlos. Madrid. España.

Correspondence: P Fernández . E-mail: pfernandezgarcia2@salud.madrid.org

Reference of this article: Fernández García P, González Menchén C, Ramos Amador JT. Pneumomediastinum in pediatrics: experience in a tertiary hospital. Rev Pediatr Aten Primaria. 2022;24:e37-e44.

Published in Internet: 20-01-2022 - Visits: 1758

Abstract

Introduction: pneumomediastinum is defined as the presence of air outside the mediastinum. It is an infrequent pathology beyond the neonatal period, which frequently occurs in young and thinly built males.

Material and methods: it is designed a descriptive study of case series, retrospective 2009-2016 and prospective 2016-2019. All the patients between 6 months and 18 years who had the pneumomedistinum diagnosis in our center were included. Eight patients were included, and epidemiological, clinical, diagnostic and therapeutic variables were analyzed.

Results: 87% of our cases had a spontaneous pneumomediastinum diagnosis, 37% of them had predisposing factors such as toxic consumption, flights, Valsava or infections. The most frequent reason for consultation was chest pain (75%), followed by dyspnea (37%), palpitations and fever (12.5% respectively). On physical examination, the most prevalent sign was subcutaneous emphysema (37%) followed by Hamman's sign (12.5%). The diagnosis was based on the clinic and imaging tests. All cases were confirmed with chest radiography and only one required CT for the confirmation. Respiratory support wasn't required, and the average hospital stay was about 2 days.

Conclusions: pneumomediastinum is usually a benign and self-limited condition. Despite its low incidence it is a pathology that should be included in the differential diagnosis of chest pain due to its potential severity as it can spread to subcutaneous, endothoracic, peritoneal or spinal tissue.

Keywords

Chest pain Dyspnea Hamman Pneumomediastinum Young men

 

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