Pneumomediastinum,subcutaneous emphysema,and pneumothorax
after a pulmonary function testing in a patient with bleomycin-induced interstitial
pneumonitis
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Authors: | Mariana Sponholz Araujo Frederico Leon Arrabal Fernandes Fernando Uliana Kay Carlos Roberto Ribeiro Carvalho |
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Abstract: | Spontaneous pneumomediastinum is an uncommon event, the clinical picture of which
includes retrosternal chest pain, subcutaneous emphysema, dyspnea, and dysphonia. The
pathophysiological mechanism involved is the emergence of a pressure gradient between
the alveoli and surrounding structures, causing alveolar rupture with subsequent
dissection of the peribronchovascular sheath and infiltration of the mediastinum and
subcutaneous tissue with air. Known triggers include acute exacerbations of asthma
and situations that require the Valsalva maneuver. We described and documented with
HRCT scans the occurrence of pneumomediastinum after a patient with bleomycin-induced
interstitial lung disease underwent pulmonary function testing. Although uncommon,
the association between pulmonary function testing and air leak syndromes has been
increasingly reported in the literature, and lung diseases, such as interstitial lung
diseases, include structural changes that facilitate the occurrence of this
complication. |
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Keywords: | Mediastinal emphysema Subcutaneous emphysema Spirometry Bleomycin |
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