A Rare Cause of Chest Pain: Spontaneous Pneumomediastinum

Year 2021, Volume: 4 Issue: 3, 110 - 113, 30.09.2021

Özgür Önen , Sercan Aydın , Miraç Koç , Fatma Mutlu Kukul Güven

Abstract

Aim: Spontaneous pneumomediastinum (SPM) is the presence of free air in the mediastinum without any clear reason. It is a rare, self-limiting disease that occurs mostly in young men. Although radiographic imaging is usually sufficient for the diagnosis, thoracic computed tomography may be required in suspicious cases and to determine the etiology. The conservative approach is sufficient in the treatment.
In this report, we present a 23-year-old male patient who presented to the emergency department due to chest pain and was diagnosed with spontaneous pneumomediastinum.

Case: 23-year-old male patient presented to the emergency department with chest pain. His general condition was good, and he was conscious. Systemic physical examination and electrocardiogram were normal. Free air was detected in the paratracheal area on the posteroanterior (PA) chest X-ray. He was admitted to the thoracic surgery service for follow-up and treatment with the diagnosis of pneumomediastinum.

Conclusion: Spontaneous pneumomediastinum should definitely be considered in the differential diagnosis of young patients presenting to the emergency department with chest pain. Clinical suspicion is the most valuable step for the diagnosis of spontaneous pneumomediastinum. Although PA chest X-ray is mostly sufficient for diagnosis, thoracic computed tomography is necessary to determine the etiology and follow-up.

Keywords

Pneumomediastinum, emergency department, chest pain

Göğüs Ağrısının Nadir Bir Nedeni: Spontan Pnömomediastinum

Abstract

Amaç: Spontan pnömomediastinum (SPM), kesin bir neden olmaksızın mediastende serbest hava bulunmasıdır. Çoğunlukla genç erkeklerde, nadir görülen, kendi kendini sınırlayan bir hastalıktır. Tanı için genellikle radyografik görüntüleme yeterli olmakla birlikte, şüpheli durumlarda ve etiyolojiyi belirlemek için toraks bilgisayarlı tomografi gerekebilir. Tedavide konservatif yaklaşım yeterlidir.
Bu yazıda göğüs ağrısı nedeniyle acil servise başvuran ve spontan pnömomediastinum tanısı konulan 23 yaşında erkek hasta sunuldu.

Olgu: 23 yaşında erkek hasta göğüs ağrısı şikayeti ile acil servise başvurdu. Genel durumu iyi, bilinci açıktı. Sistemik fizik muayene ve elektrokardiyogram normaldi. Posteroanterior (PA) akciğer grafisinde paratrakeal alanda serbest hava tespit edildi. Pnömomediastinum tanısıyla takip ve tedavi amacıyla göğüs cerrahisi servisine yatırıldı.

Sonuç: Acil servise göğüs ağrısı ile başvuran genç hastaların ayırıcı tanısında spontan pnömomediastinum mutlaka düşünülmelidir. Spontan pnömomediastinum tanısı için klinik şüphe en değerli adımdır. PA akciğer grafisi çoğunlukla tanı için yeterli olsa da etiyolojiyi belirlemek ve takip için toraks bilgisayarlı tomografi gereklidir.

Keywords

Pnömomediastinum, acil servis, göğüs ağrısı

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