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Acil serviste spontan pnömomediastinum tanılı hastaların değerlendirilmesi

Year 2019, Volume: 44 Issue: 4, 1155 - 1159, 29.12.2019
https://doi.org/10.17826/cumj.508742

Abstract

Amaç: Bu çalışmanın amacı acil serviste spontan pnömomediastinum (SPM) tanısı alan hastaların retrospektif olarak değerlendirilmesidir. 

Gereç ve Yöntem: Tek merkezli retrospektif olarak planlanan çalışmamızda Ocak 2010 - Aralık 2017 tarihleri arasında acil serviste SPM tanısı alan hastaların verileri analiz edildi. Sekonder pnömomediastinum tanısı alan hastalar (travmatik, girişimsel işlem yâda cerrahi sonrası, enfeksiyonlar) çalışma dışı bırakıldı

Bulgular: SPM tanısı alan 31 hastanın yaş ortalaması 48.35±20.80/yıl olup  %74’ü (n=23) erkek idi. Erkeklerde SPM gelişimi anlamlı oranda fazla idi  En sık eşlik eden hastalık kronik obstruktif akciğer hastalığı idi. En sık semptom nefes darlığı idi. Hastaların % 61,29’u sigara kullanıcısıydı. Hastalığı en fazla tetikleyen faktör %32 oranında fiziksel efor idi. Hastaların %35.5’i sonbahar % 32.3’ü ilkbahar mevsiminde acil servise müracaat ettiği tespit edildi. Hamman's işareti hastaların %25.8’inde mevcuttu. Hastanede yatış süresi ortalama 5.61±5.57 iken acil serviste mortalite görülmedi.

Sonuç:  Acil serviste akut göğüs ağrısı ve nefes darlığı ile başvuran hastalarda ayırıcı tanı da SPM düşünülmelidir.


References

  • 1. Smith BA, Ferguson DB. Disposition of spontaneous pneumomediastinum. The American journal of emergency medicine. 1991;9(3):256-9.
  • 2. Abolnik I, Lossos IS, Breuer R. Spontaneous pneumomediastinum: a report of 25 cases. Chest. 1991;100(1):93-5.
  • 3. Koullias GJ, Korkolis DP, Wang XJ, Hammond GL. Current assessment and management of spontaneous pneumomediastinum: experience in 24 adult patients. European journal of cardio-thoracic surgery. 2004;25(5):852-5.
  • 4. Newcomb AE, Clarke CP. Spontaneous pneumomediastinum: a benign curiosity or a significant problem? Chest. 2005;128(5):3298-302.
  • 5. Maravelli AJ, Skiendzielewski JJ, Snover W. Pneumomediastinum acquired by glass blowing. The Journal of emergency medicine. 2000;19(2):145-7.
  • 6. Marasco RD, Loizzi D, Ardò NP, Fatone FN, Sollitto F. Spontaneous Pneumomediastinum After Electronic Cigarette Use. The Annals of thoracic surgery. 2018;105(6):e269-e71.
  • 7. Caceres M, Ali SZ, Braud R, Weiman D, Garrett Jr HE. Spontaneous pneumomediastinum: a comparative study and review of the literature. The Annals of thoracic surgery. 2008;86(3):962-6.
  • 8. Werne C, Ulreich S. An unusual presentation of spontaneous pneumomediastinum. Annals of emergency medicine. 1985;14(10):1010-3.
  • 9. Munsell WP. Pneumomediastinum: a report of 28 cases and review of the literature. JAMA. 1967;202(8):689-93.
  • 10. Esayag Y, Furer V, Izbicki G. Spontaneous pneumomediastinum: is a chest x-ray enough? A single center case series. Sat. 2008;2:18.
  • 11. Manço JC, Terra-Filho J, Silva GA. Pneumomediastinum, pneumothorax and subcutaneous emphysema following the measurement of maximal expiratory pressure in a normal subject. Chest. 1990;98(6):1530-2.
  • 12. Romero KJ, Trujillo MH. Spontaneous pneumomediastinum and subcutaneous emphysema in asthma exacerbation: The Macklin effect. Heart & Lung: The Journal of Acute and Critical Care. 2010;39(5):444-7.
  • 13. Gerazounis M, Athanassiadi K, Kalantzi N, Moustardas M. Spontaneous pneumomediastinum: a rare benign entity. The Journal of thoracic and cardiovascular surgery. 2003;126(3):774-6.
  • 14. Sakai M, Murayama S, Gibo M, Akamine T, Nagata O. Frequent cause of the Macklin effect in spontaneous pneumomediastinum: demonstration by multidetector-row computed tomography. Journal of computer assisted tomography. 2006;30(1):92-4.
  • 15. Weissberg D, Weissberg D. Spontaneous mediastinal emphysema. European journal of cardio-thoracic surgery. 2004;26(5):885-8.

Evaluation of patients with spontaneous pneumomedıastınum in emergency department

Year 2019, Volume: 44 Issue: 4, 1155 - 1159, 29.12.2019
https://doi.org/10.17826/cumj.508742

Abstract

Purpose: The aim of this study was to retrospectively evaluate the patients with spontaneous pneumomediastinum (SPM) diagnosis in the emergency department

Materials and Methods: Data of the patients diagnosed by the SPM in the emergency department between January 2010 and December 2017 was analyzed in our study planned as monocenter and retrospective. The patients diagnosed by secondary pneumomediastinum (traumatic, invasive operation or postoperative, infections) were excluded from the study. 

Results: Mean age of 31 patients diagnosed by the SPM was 48.35±20.80/years and 74% of them (n=23) were male. The SPM development was significantly more in the males. The most accompanying disease was the chronic obstructive respiratory disease. The most frequent symptom was the shortness of breath. 61.29% of the patients were the smoker. The most disease triggering factor was the physical effort at the rate of 32%. It was determined that 35.5% of the patients were applied to the emergency department in the autumn and 32.3% of them in the spring. Hamman’s sign existed in 25.8% of the patients.  While the hospitalization period was mean 5.61±5.57, no mortality was seen in the emergency department. 

Conclusion:  The SPM should be considered as a differential diagnosis in the patients applied to the emergency department with acute chest pain and shortness of breath. 


References

  • 1. Smith BA, Ferguson DB. Disposition of spontaneous pneumomediastinum. The American journal of emergency medicine. 1991;9(3):256-9.
  • 2. Abolnik I, Lossos IS, Breuer R. Spontaneous pneumomediastinum: a report of 25 cases. Chest. 1991;100(1):93-5.
  • 3. Koullias GJ, Korkolis DP, Wang XJ, Hammond GL. Current assessment and management of spontaneous pneumomediastinum: experience in 24 adult patients. European journal of cardio-thoracic surgery. 2004;25(5):852-5.
  • 4. Newcomb AE, Clarke CP. Spontaneous pneumomediastinum: a benign curiosity or a significant problem? Chest. 2005;128(5):3298-302.
  • 5. Maravelli AJ, Skiendzielewski JJ, Snover W. Pneumomediastinum acquired by glass blowing. The Journal of emergency medicine. 2000;19(2):145-7.
  • 6. Marasco RD, Loizzi D, Ardò NP, Fatone FN, Sollitto F. Spontaneous Pneumomediastinum After Electronic Cigarette Use. The Annals of thoracic surgery. 2018;105(6):e269-e71.
  • 7. Caceres M, Ali SZ, Braud R, Weiman D, Garrett Jr HE. Spontaneous pneumomediastinum: a comparative study and review of the literature. The Annals of thoracic surgery. 2008;86(3):962-6.
  • 8. Werne C, Ulreich S. An unusual presentation of spontaneous pneumomediastinum. Annals of emergency medicine. 1985;14(10):1010-3.
  • 9. Munsell WP. Pneumomediastinum: a report of 28 cases and review of the literature. JAMA. 1967;202(8):689-93.
  • 10. Esayag Y, Furer V, Izbicki G. Spontaneous pneumomediastinum: is a chest x-ray enough? A single center case series. Sat. 2008;2:18.
  • 11. Manço JC, Terra-Filho J, Silva GA. Pneumomediastinum, pneumothorax and subcutaneous emphysema following the measurement of maximal expiratory pressure in a normal subject. Chest. 1990;98(6):1530-2.
  • 12. Romero KJ, Trujillo MH. Spontaneous pneumomediastinum and subcutaneous emphysema in asthma exacerbation: The Macklin effect. Heart & Lung: The Journal of Acute and Critical Care. 2010;39(5):444-7.
  • 13. Gerazounis M, Athanassiadi K, Kalantzi N, Moustardas M. Spontaneous pneumomediastinum: a rare benign entity. The Journal of thoracic and cardiovascular surgery. 2003;126(3):774-6.
  • 14. Sakai M, Murayama S, Gibo M, Akamine T, Nagata O. Frequent cause of the Macklin effect in spontaneous pneumomediastinum: demonstration by multidetector-row computed tomography. Journal of computer assisted tomography. 2006;30(1):92-4.
  • 15. Weissberg D, Weissberg D. Spontaneous mediastinal emphysema. European journal of cardio-thoracic surgery. 2004;26(5):885-8.
There are 15 citations in total.

Details

Primary Language Turkish
Subjects Health Care Administration
Journal Section Research
Authors

Mehmet Çağrı Göktekin 0000-0001-7911-8965

Publication Date December 29, 2019
Acceptance Date March 2, 2019
Published in Issue Year 2019 Volume: 44 Issue: 4

Cite

MLA Göktekin, Mehmet Çağrı. “Acil Serviste Spontan pnömomediastinum tanılı hastaların değerlendirilmesi”. Cukurova Medical Journal, vol. 44, no. 4, 2019, pp. 1155-9, doi:10.17826/cumj.508742.