Abstract
Background: Due to its rarity there is no clear policy on the management of spontaneous pneumomediastinum
(SPM). Methods: We treated 23 SPM patients between January 1 996 and November 2 006. There were 20
males and 3 females and their mean age was 27. Clinical records of the patients were
collected and analyzed. Results: The most frequent symptoms were neck swelling (n = 20) and rhinolalia (n = 15). Onset
of the symptoms was acute. A preceding factor was found in 19 (83 %) patients; these
included vigorous cough, forced physical activity, vigorous sneezing and enormous
efforts during spontaneous vaginal delivery. Chest X‐ray was sufficient to show mediastinal
free air in 18 patients. Computerized chest tomography showed pneumomediastinum in
all patients. Twenty patients were treated expectantly. Subcutaneous air drainage
was needed to drain massive subcutaneous emphysema in three patients. Conclusions: Acute onset of typical symptoms, the existence of a preceding factor and the exclusion
of other possible causes of pneumomediastinum with the help of CT are sufficient to
make a diagnosis of SPM. A surgical intervention is generally not needed for the treatment
of this entity.
Key words
thoracic surgery - spontaneous pneumomediastinum - diagnosis and treatment
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Dr. MD Mehmet Zeki Gunluoglu
Yedikule Chest Diseases and Thoracic Surgery Education and Research Hospital
Thoracic Surgery
Yedikule Gogus Hastanesi, 2. cerrahi klinigi, Zeytinburnu
34000 Istanbul
Turkey
Telefon: + 90 21 26 64 17 00
Fax: + 90 21 25 47 22 33
eMail: mzekigun@gmail.com
