Definition
Pneumomediastinum is a pathological condition characterized by the presence of free air in the mediastinal cavity (space between the lungs).
Usually, pneumomediastinum is associated with respiratory disorders, but it can also derive from traumas, infections or lesions of the air or digestive tract (including iatrogenic ones, consequent to invasive medical or surgical procedures on the chest).
Pneumomediastinum is also known as a complication in patients with severe asthma attacks. In this case, the presence of air in the mediastinal gap may be secondary to the rupture of the pulmonary alveoli. This occurs due to a sharp increase in intra-alveolar pressure or reduced pressure in the pulmonary interstice; Possible causes of alveolar rupture include inflammation of the bronchioles and the alveoli themselves.
At other times, pneumomediastinum can result from gastrointestinal perforation or an esophageal rupture.
Pneumomediastinum causes intense thoracic retrosternal pain associated with respiratory difficulty. The physical examination can demonstrate the presence of subcutaneous emphysema at the base of the neck (passage of air in the subcutaneous tissues) and the sign of Hammam (crepitus in the precordial site and reduction of the intensity of the heart tone). The diagnosis is confirmed by chest X-ray.
Treatment must be undertaken urgently to surgically repair any injuries.
Possible Causes * of Pneumomediastinum
- Asthma
- Bronchitis
- Esophageal diverticula
- Ingestion of caustic substances
- Pleurisy
- Pneumonia
- Meconium aspiration syndrome
- Decompression syndrome
- Esophagus tumor
- Peptic ulcer
