Korean J Asthma Allergy Clin Immunol.  2006 Dec;26(4):310-313.

A Case of Spontaneous Pneumomediastinum during an Acute Asthma Attack

Abstract

Spontaneous pneumomediastinum is a rare complication of asthma. During acute attack of asthma alveolar overdistension or rupture due to excessive air pressure results in the leakage of air from the respiratory tract and through dissection along great vessel sheaths to the mediastinum and pericardium. The clinical diagnosis is based on the symptom triads of chest pain, dyspnea, and subcutaneous emphysema, and is also based on Hamman's sign. The diagnosis is confirmed by chest radiography. The main differential diagnosis is esophageal perforation, which requires esopha-gography with contrast when there is the slightest doubt in the diagnosis. Management consists of eradication of the underlying cause, rest, analgesics, and simple clinical monitoring. Predisposing factors should be identified and managed to prevent recurrence. We report a case of subcutaneous emphysema in a 15-year-old patient with asthma who presented with spontaneous pneumomediastinum and pneumopericardium.

MeSH Terms

Adolescent
Air Pressure
Analgesics
Asthma*
Causality
Chest Pain
Diagnosis
Diagnosis, Differential
Dyspnea
Esophageal Perforation
Humans
Mediastinal Emphysema*
Mediastinum
Pericardium
Pneumopericardium
Radiography
Recurrence
Respiratory System
Rupture
Subcutaneous Emphysema
Thorax
Analgesics