Spontaneous Pneumomediastinum Presenting With Neck Swelling

Attila Aydın; Murtaza Kaya; Sedat Bilge; Erdem Çevik; Veysel Balcı; Cemile Aydın

Spontaneous Pneumomediastinum Presenting With Neck Swelling

Year 2019, Issue: 1, 104 - 106, 01.03.2019

Attila Aydın Murtaza Kaya Sedat Bilge Erdem Çevik Veysel Balcı Cemile Aydın

Abstract

Spontaneous Pneumomediastinum SPM is a very rare condition with an incidence of 1/30.000 and 1/44.500, and mostly seen in young men. The present article reports a case of SPM with neck swelling in the Emergency Department ED . A 24-year-old male patient with fever and swelling on both sides of his neck presented at the ED. Physical examination revealed swelling on both parotid glands, neck and facial area. The pulmonary examination revealed a swelling starting from the upper side of the chest and extending toward the neck region and palpation revealed crepitation from the upper wall of the chest to both temporal fossae. Linear air radiolucency was seen in the posteroanterior chest x-ray. A Cervico-Thoracic CT scan revealed “showed” diffuse bilateral and symmetrical emphysema. SPM was diagnosed. He was admitted to the Thoracic Surgery Department for treatment and followup. Emergency physicians should consider SPM in the differential diagnosis of patients presenting with neck swelling. It should not be forgotten that close patient follow-up is required due to the possibility of severe complications

Keywords

emphysema, macklin effect, spontaneous pneumomediastinum, subcutaneous

References

1. Okada M, Adachi H, Shibuya Y, Ishikawa S, Hamabe Y. Diagnosis and treatment of patients with spontaneous pneumomediastinum. Resp Invest 2014;52:36–40. [CrossRef]
2. Orton J, Collette E. Pneumomediastinum presenting as left periorbital subcutaneous emphysema. Am J Emerg Med 2015;33:1842.e1–2. [CrossRef]
3. Hogan F, McCullough C, Rahman A. Spontaneous pneumomediastinum: an important differential in acute chest pain. BMJ Case Rep 2014;2014. [CrossRef]
4. Huon LK, Chang YL, Wang PC, Chen PY. Head and neck manifestations of spontaneous pneumomediastinum. Otolaryngol Head Neck Surg 2012;146:53–7. [CrossRef]
5. Semedo FHMA, Silva RS, Pereira S, Alfaiate T, Costa T, Fernandez P, Pereira A. Spontaneous pneumomediastinum: case report. Revist Assoc Med Brasil (1992) 2012;58:355–7. [CrossRef]
6. Murayama S, Gibo S. Spontaneous pneumomediastinum and Macklin effect: Overview and appearance on computed tomography. W J Radiology 2014;6:850–4. [CrossRef]
7. Ho AS, Ahmed A, Huang JS, Menias CO, Bhalla S. Multidetector computed tomography of spontaneous versus secondary pneumomediastinum in 89 patients: can multidetector computed tomography be used to reliably distinguish between the 2 entities? J Thoracic Imag 2012;27:85–92. [CrossRef]
8. Lee CY, Wu CC, Lin CY. Etiologies of spontaneous pneumomediastinum in children of different ages. Pediatr Neonat 2009;50:190–5. [CrossRef]
9. Huon LK, Chang YL, Wang PC, Chen PY. Head and neck manifestations of spontaneous pneumomediastinum. Otolaryngology Head Neck Surg 2012;146:53–7. [CrossRef]
10. Kaneki T, Kubo K, Kawashima A, Koizumi T, Sekiguchi M, Sone S. Spontaneous pneumomediastinum in 33 patients: yield of chest computed tomography for the diagnosis of the mild type. Respiration 2000;67:408–11. [CrossRef]
11. Sun D, Chen F, Wang C. An unusual etiology of abdominal pain and spontaneous pneumomediastinum in a young adult. Am J Emerg Med 2014;32:947.e1–2. [CrossRef]

BOYUN ŞIŞLIĞI ILE BAŞVURAN SPONTAN PNÖMOMEDIASTINUM

Year 2019, Issue: 1, 104 - 106, 01.03.2019

Attila Aydın Murtaza Kaya Sedat Bilge Erdem Çevik Veysel Balcı Cemile Aydın

Abstract

Spontan Pnömomediastinum SPM yaklaşık 1/30000 and 1/44500 arasında insidansa sahip çok nadir görülen bir durum olmakla beraber çoğunlukla genç erkeklerde görülür. Bu makalede Acil Servis’e boyunda şişlik şikayeti ile başvuran SPM olgusunu rapor ettik. 24 yaşında erkek hasta Acil Servis’e ateş ve boynun her iki tarafında şişlik şikayeti ile başvurdu. Fizik incelemede; her iki parotis bezi, boyun ve yüz bölgesinde şişlik tespit edildi. Akciğer muayenesinde; inspeksiyonda; göğüs üst yüzden başlayıp boyun bölgesine doğru devam eden şişlik ve palpasyonda göğüs üst duvarından başlayıp her iki temporal fossaya kadar krepitasyon alındı. Akciğer x-ray grafide radyolusens çizgiler görüldü. Servikotorasik bilgisayarlı tomografide, diffüz bilateral ve simetrik amfizem görüldü. SPM tanısı konuldu, tedavi ve takip amacıyla Göğüs Cerrahi’si Kliniği’ne yatırıldı. Acil servis hekimleri; boyunda şişlik şikayeti ile başvuran hastalarda ayırıcı tanıda mutlaka SPM’yi akla getirmelidir. Ciddi komplikasyonlar açısından hastaların yakın gözlem gerektiği unutulmamalıdır

Keywords

Amfizem, macklin efekt, spontan pnömomediastinum, subkütanöz

References

1. Okada M, Adachi H, Shibuya Y, Ishikawa S, Hamabe Y. Diagnosis and treatment of patients with spontaneous pneumomediastinum. Resp Invest 2014;52:36–40. [CrossRef]
2. Orton J, Collette E. Pneumomediastinum presenting as left periorbital subcutaneous emphysema. Am J Emerg Med 2015;33:1842.e1–2. [CrossRef]
3. Hogan F, McCullough C, Rahman A. Spontaneous pneumomediastinum: an important differential in acute chest pain. BMJ Case Rep 2014;2014. [CrossRef]
4. Huon LK, Chang YL, Wang PC, Chen PY. Head and neck manifestations of spontaneous pneumomediastinum. Otolaryngol Head Neck Surg 2012;146:53–7. [CrossRef]
5. Semedo FHMA, Silva RS, Pereira S, Alfaiate T, Costa T, Fernandez P, Pereira A. Spontaneous pneumomediastinum: case report. Revist Assoc Med Brasil (1992) 2012;58:355–7. [CrossRef]
6. Murayama S, Gibo S. Spontaneous pneumomediastinum and Macklin effect: Overview and appearance on computed tomography. W J Radiology 2014;6:850–4. [CrossRef]
7. Ho AS, Ahmed A, Huang JS, Menias CO, Bhalla S. Multidetector computed tomography of spontaneous versus secondary pneumomediastinum in 89 patients: can multidetector computed tomography be used to reliably distinguish between the 2 entities? J Thoracic Imag 2012;27:85–92. [CrossRef]
8. Lee CY, Wu CC, Lin CY. Etiologies of spontaneous pneumomediastinum in children of different ages. Pediatr Neonat 2009;50:190–5. [CrossRef]
9. Huon LK, Chang YL, Wang PC, Chen PY. Head and neck manifestations of spontaneous pneumomediastinum. Otolaryngology Head Neck Surg 2012;146:53–7. [CrossRef]
10. Kaneki T, Kubo K, Kawashima A, Koizumi T, Sekiguchi M, Sone S. Spontaneous pneumomediastinum in 33 patients: yield of chest computed tomography for the diagnosis of the mild type. Respiration 2000;67:408–11. [CrossRef]
11. Sun D, Chen F, Wang C. An unusual etiology of abdominal pain and spontaneous pneumomediastinum in a young adult. Am J Emerg Med 2014;32:947.e1–2. [CrossRef]

There are 11 citations in total.

Details

Primary Language	English
Journal Section	Research Article
Authors	Attila Aydın Murtaza Kaya Sedat Bilge Erdem Çevik Veysel Balcı Cemile Aydın
Publication Date	March 1, 2019
Published in Issue	Year 2019Issue: 1

Cite

EndNote	Aydın A, Kaya M, Bilge S, Çevik E, Balcı V, Aydın C (March 1, 2019) Spontaneous Pneumomediastinum Presenting With Neck Swelling. Acıbadem Üniversitesi Sağlık Bilimleri Dergisi 1 104–106.