Pol. Merkur. Lek (Pol. Med. J.), 2016, XLI/242: 093-096 Maximize

Pol. Merkur. Lek (Pol. Med. J.), 2016, XLI/242: 093-096

Title: Pneumomediastinum – a case report 

Authors: Szmygin-Milanowska K, Grzywa-Celińska A, Krusiński A, Cielma M, Wawrzecka A, Emeryk-Maksymiuk J, Milanowski J. 

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Pneumomediastinum – a case report

Szmygin-Milanowska K1, Grzywa-Celińska A1, Krusiński A4, Cielma M4, Wawrzecka A2, Emeryk-Maksymiuk J1,3, Milanowski J1.

Medical University of Lublin, Poland: 1Chair and Department of Pneumonology, Oncology and Allergology; 2Chair and Department of Otolaryngology and Laryngological Oncology; 3 Chair of Internal Medicine and Department of Internal Medicine in Nursing; 4Students Scientific Association at Department of Pneumonology, Oncology and Allergology

Pneumomediastinum is a rare disorder which often occurs without symptoms. It is sometimes a result of an injury but most often it is spontaneous. Pneumothorax may be iatrogenic; one of the reasons might be tracheotomy. Pneumomediastinum in some cases may be the threat to life and health. In this rare cases surgical intervention is needed, however pneumomediastinum is usually spontaneously absorbed.
The aim of this study
was to present the differential diagnosis of pneumomediastinum based on the case of a 60-year-old woman with tracheostomy, diagnosed eight years ago with generalized irreversible narrowing of the trachea and bronchi (suspicion of tracheobronchopathia osteochondroplastica).
A case report
. Patient complained of increasing shortness of breath, dry cough and symptoms of upper respiratory tract infections for 2 weeks. In chest CT pneumomediastinum was detected. During bronchoscopy and endoscopic examination of trachea and larynx, no focal lesions of upper respiratory tract and bronchi were detected. By using noninvasive treatment, clinical improvement was achieved. In control chest CT, significant resorption of the air from the mediastinum was detected. Pneumomediastinum occurs often without characteristic symptoms or can be asymptomatic and it is discovered incidentally. If there is no obvious trauma, the cause is usually unknown. In the presented case, after exclusion of the majority of possible causes, we suspected that pneumomediastinum was a complication of tracheotomy but it was not confirmed in endoscopy. It might have been a complication of severe coughing in the course of upper respiratory tract infection or it might have been spontaneous.
. Pneumomediastinum is usually not dangerous, however in some cases it may be a threat to life and health. Therefore, it is necessary to perform CT when it is suspected. The treatment is usually limited to administration of oxygen therapy, antitussives and analgesics and bed rest.

Key words: pneumomediastinum, tracheotomy, tracheostomy

Pol Med J, 2016; XLI (242); 93–96