| Autor: |
Santini, Mihovil, Nikše, Lana, Mioč, Pavao, Santini, Jakov, Tokić, Iva, Zeljković, Ivan |
| Předmět: |
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| Zdroj: |
Lijecnicki Vjesnik; 2023 Supplement, Vol. 145, p59-59, 1/2p |
| Abstrakt: |
INTRODUCTION/OBJECTIVES: Spontaneous pneumomediastinum (SPM) is a rare condition in young adults, usually affecting young healthy males with underlying pulmonary disease, which can be extremely rarely complicated with pneumopericardium (SPP). CASE PRESENTATION: A 22-year-old female was admitted to the emergency department (ED) with an acute onset of dyspnea and severe pain in the left side of the neck, chest and left arm, especially when leaning forward. On admission, she was afebrile and physical examination revealed symmetric, clear breath sounds and almost inaudible heart beats without Hamman’s sign. An arterial blood gas analysis revealed mild hypocapnia. An X-ray showed pneumomediastinum, and subsequent chest CT (computerized tomography) scan confirmed extensive pneumomediastinum with pneumopericardium up to 5 mm in thickness. She did not have any pre-existing pulmonary disease or other predisposing risk factors (heavy lifting, exercise, trauma). A chest CT scan showed no signs of pulmonary bullae, or any structural abnormalities in the bronchi or the esophagus. Echocardiography was done using subxiphoid projection, which was the only one revealing the heart, and showed no pathology and no hemodynamic repercussions from the SPP. The therapy was absolute bed rest, peroral analgesia and oxygen supply (4 L/min). During hospitalization, she was afebrile and no antibiotics were prescribed. The follow-up chest X-ray showed a complete resolution of pneumomediastinum and pneumopericardium and she was symptom free. CONCLUSION: When evaluating a young adult who presents with dyspnea, it is important for emergency physicians to interpret the x-rays carefully in order to look for pathology like SPM if there is reasonable clinical doubt. [ABSTRACT FROM AUTHOR] |
| Databáze: |
Complementary Index |
| Externí odkaz: |
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