Çocukluk Çağında Spontan Pnömomediastinum: Antalya’ daki Üçüncü Basamak bir Merkezin Deneyimi

Öz

ÖZ Amaç: Spontan pnömomediastinumlu çocuk olguların demografik verilerini, klinik bulgularını, komplikasyonlarını ve prognozlarını değerlendirmek. Gereç ve Yöntemler: Ocak 2009- Ağustos 2019 tarihleri arasında Sağlık Bilimleri Üniversitesi Antalya Eğitim ve Araştırma Hastanesinden pnömomediastinum tanısıyla taburcu edilen 15 çocuk olgunun demografik özellikleri, tetikleyici faktörleri, altta yatan hastalıkları, semptomları, bulguları, hastanede kalış süreleri, komplikasyonları, tedavileri ve sonuçları içeren verileri geriye dönük incelendi. Bulgular: Spontan pnömomediastinumu olan 12 erkek (% 80) ve üç kızın (% 20) ortalama yaşları 11.33 ± 7 yıldı (4ay-17 yıl). En sık tetikleyici faktör solunum yolu enfeksiyonuna bağlı şiddetli öksürük ve / veya bronkospazmdı. Sekiz olguya akciğer grafisinde pnömomediastinum saptanmasına rağmen toraks bilgisayarlı tomografi de çekilmişti. Üç (% 20) olgunun toraks bilgisayarlı tomografisinde pnömoraşisi mevcuttu. Yedi (% 46.6) olguda pnömomediastinuma pnömotoraks eşlik etmekteydi. Ortalama hastanede kalış süreleri 8.4 ± 4.5 (3-18) gündü. Bir hasta dışında tümü iyileşerek taburcu edildi ve 1-72 ay boyunca takip edildi. Takip süresi boyunca olgularda nüks saptanmadı. Sonuçlar: Spontan pnömomediastinum çocukluk çağında nadir görülen, kendi kendini sınırlandıran bir durumdur ve prognozu altta yatan hastalığa bağlıdır. Spontan pnömomediastinumlu çocuk olgulara rutin akciğer tomografisi çekilip çekilmeyeceği henüz net değildir. Tüm spontan pnömomediastinumlu olgulara akciğer tomografisi çekilirse pnömoraşi daha sık tespit edilebilir. Anahtar Sözcükler: Spontan pnömomediastinum, Pnömoraşi, Pnömomediastinum, Pnömotoraks

Anahtar Kelimeler

• Spontan pnömomediastinum
• Pnömoraşi
• Pnömomediastinum
• Pnömotoraks

Spontaneous Pneumomediastinum in Children: The Experience of a Pediatric Tertiary Center in Antalya

Abstract

Objective: To evaluate the demographic data, clinical findings, complications and prognosis of children with spontaneous pneumomediasinum. Material and Methods: This was a retrospective chart review including demographic characteristics, trigger factors, underlying diseases, symptoms, signs, length of hospital stay, complications, treatments, and outcomes of 15 children aged <18 years with a discharge diagnosis of pneumomediastinum, between January 2009 and August 2019, at the University of Health Sciences Antalya Training and Research Hospital. Results: The mean age of the 12 boys (80%) and three girls (20%) with spontaneous pneumomediastinum was 11.33 ± 7 years, with a range of 4 months to 17 years. The most common trigger factor was severe cough and/or bronchospasm due to respiratory tract infection. In 8 patients with pneumomediastinum seen radiologically on the chest X-ray, thoracic computed tomography was also taken. Pneumorrhachis was determined on the thoracic computed tomography of 3 (20%) patients. Pneumomediastinum was accompanied by pneumothorax in 7 (46.6%) cases. The mean length of hospital stay was 8.4 ± 4.5 days (3-18 days). All patients except one recovered and were discharged and followed up for 1-72 months. Hospital records showed no recurrence during the follow-up period. Conclusions: Spontaneous pneumomediastinum is a rare, self-limiting condition in childhood and the prognosis depends on the underlying disease. The problem of whether or not routine chest computed tomography scanning should be performed in children with spontaneous pneumomediastinum has not yet been resolved, but if chest computed tomography scanning is performed in every patient with spontaneous pneumomediastinum, pneumorrachis might be detected more frequently. Key Words: Spontaneous pneumomediastinum, Pneumorrhachis, Pneumomediastinum, Pneumothorax

Keywords

• Spontaneous pneumomediastinum
• Pneumorrhachis
• Pneumomediastinum
• Pneumothorax

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