Pneumomediastinum 3824013 217378199 2008-06-05T19:47:47Z Gene Hobbs 3121896 /* References */ update tag - 2 column {{Infobox_Disease | Name = {{PAGENAME}} | Image = Subcutaneous emphysema chest cropped.jpg| Caption = A CT scan showing air in the mediastinum| DiseasesDB = 29460 | ICD10 = {{ICD10|J|98|2|j|95}}, {{ICD10|P|25|2|p|20}} | ICD9 = {{ICD9|518.1}}, {{ICD9|770.2}} | ICDO = | OMIM = | MedlinePlus = 000084 | eMedicineSubj = ped | eMedicineTopic = 1832 | eMedicine_mult = {{eMedicine2|emerg|469}} | MeshID = D008478 | }} '''Pneumomediastinum''' (from [[Greek language|Greek]] ''pneuma'' - "air", also known as '''mediastinal emphysema''') is a condition in which air is present in the [[mediastinum]]. First described in [[1819]] by [[René Laennec]],<ref>Laënnec RTH. De l’auscultation médiate ou Traité du Diagnostic des Maladies des Poumon et du Coeur. 1st ed. Paris: Brosson & Chaudé; 1819.</ref><ref name="pmid17048358">{{cite journal |author=Roguin A |title=Rene Theophile Hyacinthe Laënnec (1781-1826): the man behind the stethoscope |journal=Clinical medicine & research |volume=4 |issue=3 |pages=230–5 |year=2006 |pmid=17048358 |doi=}}</ref> the condition can result from [[physical trauma]] or other situations that lead to high pressure within the [[alveoli]] of the [[lung]], causing them to burst and leak air into the [[chest cavity]]. ==Presentation== Pneumomediastinum is uncommon, it occurs when air leaks from any part of the lung or airways into the mediastinum and is often recognized on [[auscultation]] by a "crunching" sound timed with the cardiac cycle ([[Hamman's crunch]]). [[Subcutaneous emphysema]] is a symptom. The diagnosis can be confirmed via [[chest X-ray]] showing a radiolucent outline around the heart and mediastinum or via [[ct scan|CT scanning]] of the [[thorax]]. ==Aetiology== It is most commonly caused by: * Oesophageal rupture, for example in [[Boerhaave syndrome]] * [[Asthma]] or other conditions leading to alveolar rupture It has also been associated with: * [[Mycoplasma pneumoniae]] [[pneumonia]]<ref name="pmid17899058">{{cite journal |author=Vázquez JL, Vázquez I, González ML, García-Tejedor JL, Repáraz A |title=Pneumomediastinum and pneumothorax as presenting signs in severe Mycoplasma pneumoniae pneumonia |journal= |volume= |issue= |pages= |year=2007 |pmid=17899058 |doi=10.1007/s00247-007-0611-1}}</ref> * [[anorexia]]<ref name="pmid17909893">{{cite journal |author=Hatzitolios A, Ntaios G |title=Spontaneous Pneumomediastinum May Be Associated with Both Anorexia Nervosa and Obesity |journal= |volume= |issue= |pages= |year=2007 |pmid=17909893 |doi=10.1007/s00408-007-9037-7}}</ref> * [[obesity]]<ref name="pmid17909893">{{cite journal |author=Hatzitolios A, Ntaios G |title=Spontaneous Pneumomediastinum May Be Associated with Both Anorexia Nervosa and Obesity |journal= |volume= |issue= |pages= |year=2007 |pmid=17909893 |doi=10.1007/s00408-007-9037-7}}</ref> It can be induced to assist thoracoscopic surgery.<ref name="pmid17669882">{{cite journal |author=Utsumi T, Shiono H, Fukai I, Akashi A |title=Artificial pneumomediastinum facilitates thoracoscopic surgery in anterior mediastinum |journal=Interactive cardiovascular and thoracic surgery |volume=6 |issue=3 |pages=411–2 |year=2007 |pmid=17669882 |doi=10.1510/icvts.2006.147355}} </ref> It can be caused by a pulmonary [[barotrauma]] resulting when a person moves to or from a higher pressure environment, such as when a [[Scuba diving|SCUBA diver]]<ref>{{cite journal |author=Tetzlaff K, Reuter M |title=Recurrent pulmonary barotrauma (PBT) in a previously healthy male scuba diver who suffered from repeated pneumomediastinum after shallow-water scuba dives |journal=Undersea Hyperb Med |volume=25 |issue=2 |pages=127–8 |year=1998 |pmid=9670439 |doi= |url=http://archive.rubicon-foundation.org/2412 |accessdate=2008-06-05}}</ref><ref>Dr. Richard Moon, Diver's Alert Network Vice President and Medical Director, http://www.diversalertnetwork.org/medical/articles/article.asp?articleid=40 </ref>, a [[free-diving|free-diver]]<ref>{{cite journal |author=Jacobson FL, Loring SH, Ferrigno M |title=Pneumomediastinum after lung packing |journal=Undersea Hyperb Med |volume=33 |issue=5 |pages=313–6 |year=2006 |pmid=17091828 |doi= |url=http://archive.rubicon-foundation.org/5045 |accessdate=2008-06-05}}</ref> or an [[airplane]] passenger<ref>{{cite journal |author=Nicol E, Davies G, Jayakumar P, Green ND |title=Pneumopericardium and pneumomediastinum in a passenger on a commercial flight |journal=Aviat Space Environ Med |volume=78 |issue=4 |pages=435–9 |year=2007 |month=April |pmid=17484349 |doi= |url=http://www.ingentaconnect.com/content/asma/asem/2007/00000078/00000004/art00014 |accessdate=2008-06-05 }}</ref> ascends or descends. ==References== {{reflist|2}} ==External links== * {{Chorus|00964}} {{Respiratory pathology}} {{Certain conditions originating in the perinatal period}} [[Category:Pulmonology]] {{med-sign-stub}} [[de:Mediastinalemphysem]] [[it:Pneumomediastino]] [[sv:Mediastinalemfysem]]