Pneumomediastinum: Difference between revisions
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==Background== | |||
*usually occurs with sudden increase in intra-alveolar pressure causing alveolar rupture, air dissects into pulmonary interstitium and then into mediastinum, neck, or pericardium | *usually occurs with sudden increase in intra-alveolar pressure causing alveolar rupture, air dissects into pulmonary interstitium and then into mediastinum, neck, or pericardium | ||
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*if no hemodynamic or airway compromise present, spontaneous pneumomediastinum is not a life threatening condition | *if no hemodynamic or airway compromise present, spontaneous pneumomediastinum is not a life threatening condition | ||
==Causes== | |||
*illegal drug use | *illegal drug use | ||
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*trauma | *trauma | ||
==Clinical Features== | |||
*chest pain | *chest pain | ||
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*"Hamman's Crunch" - crunching sound of heart during systole | *"Hamman's Crunch" - crunching sound of heart during systole | ||
==Workup== | |||
*ABCs | *ABCs | ||
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*Rule-out esophageal rupture by hx and exam or with esophagoscopy if indicated | *Rule-out esophageal rupture by hx and exam or with esophagoscopy if indicated | ||
==Management== | |||
*supportive | *supportive | ||
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*treat underlying cause | *treat underlying cause | ||
==Disposition== | |||
*depends on underlying cause and severity of condition | *depends on underlying cause and severity of condition | ||
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==Sources== | |||
Harwood-Nuss, Rosens | Harwood-Nuss, Rosens | ||
[[Category:Pulm]] | [[Category:Pulm]] | ||
Revision as of 12:20, 9 September 2012
Background
- usually occurs with sudden increase in intra-alveolar pressure causing alveolar rupture, air dissects into pulmonary interstitium and then into mediastinum, neck, or pericardium
- life threatening cause is esophageal rupture
- if no hemodynamic or airway compromise present, spontaneous pneumomediastinum is not a life threatening condition
Causes
- illegal drug use
- inhaling cocaine
- smoking cocaine
- smoking marijuana
- vomiting
- retching
- asthma
- coughing
- esophageal rupture
- recent endoscopy
- trauma
Clinical Features
- chest pain
- subQ emphysema in chest wall, neck, face, abdomen, scrotum
- "Hamman's Crunch" - crunching sound of heart during systole
Workup
- ABCs
- CXR
- Rule-out esophageal rupture by hx and exam or with esophagoscopy if indicated
Management
- supportive
- no specific therapy for spontaneous pneumomediastinum
- treat underlying cause
Disposition
- depends on underlying cause and severity of condition
- most pt's with spontaneous pneumomediastinum, not caused by trauma or esophageal rupture, can be safely discharged
Sources
Harwood-Nuss, Rosens