Clinical analysis of 71 spontaneous pneumomediastinum cases: an observational study from a tertiary care hospital in Japan |
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| Authors: | Kazushi Yamairi Yuki Yoshimatsu Hatsuki Shimazu Shigeki Kakuno Nobuhiko Sawa Yumiko Mizukubo Masayoshi Nishijima Kenichiro Otani Takao Kamimori Hiroshi Fujiwara |
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| Institution: | 1. Department of Respiratory Medicine, Yodogawa Christian Hospital, Osaka, Japan;2. Department of Respiratory Medicine, Iizuka Hospital, Iizuka, Japan;1. Department of Medicine, School of Medicine, Chiba University, Chiba 260-8670, Japan;2. Department of Respirology, Graduate School of Medicine, Chiba University, Chiba 260-8670, Japan;3. Health Professional Development Center, Chiba University Hospital, Chiba 260-8670, Japan;4. Department of Pulmonary Medicine, School of Medicine, International University of Health and Welfare, Chiba 286-8686, Japan;5. Department of General Thoracic Surgery, Graduate School of Medicine, Chiba University, Chiba 260-8670, Japan;6. Department of Pathology, Chiba University Hospital, Chiba 260-8670, Japan;7. Department of Hematology, Tokyo Metropolitan Cancer and Infectious Disease Center Komagome Hospital, Tokyo 113-8677, Japan;8. Department of Hematology, Graduate School of Medicine, Chiba University, Chiba 260-8670, Japan;9. Department of Hematology, School of Medicine, International University of Health and Welfare, Chiba 286-8686, Japan;1. Department of Respiratory Medicine, Kanagawa Cardiovascular and Respiratory Center, Japan;2. Department of Radiology, Kanagawa Cardiovascular and Respiratory Center, Japan;1. Department of Respiratory Medicine, Toho University School of Medicine, 6-11-1 Omori-Nishi, Ota-ku, Tokyo, 143-8541, Japan;2. Department of Physiology, School of Medicine, Faculty of Medicine, Toho University, 5-21-16 Omori-Nishi, Ota-ku, Tokyo, 143-8540, Japan;3. Division of Chest Surgery, Toho University School of Medicine, Omori-Nishi, Ota-ku, Tokyo, 6-11-1, Japan;4. Department of Advanced and Integrated Interstitial Lung Diseases Research, School of Medicine, Toho University, 5-21-16 Omori-Nishi, Ota-ku, Tokyo, 143-8540, Japan;1. Department of Respiratory Medicine, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan;2. Department of Radiology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan;3. Department of Infectious Diseases, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan;4. Department of Infection Control and Prevention, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan;5. Department of Diabetes and Metabolic Diseases, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan;6. Department of Orthopaedic Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan;1. Kanagawa Cardiovascular and Respiratory Center, Department of Respiratory Medicine, Tomioka-Higashi 6-16-1, Kanazawa-ku, Yokohama, 236-0051, Japan;2. University of Yamanashi Hospital, Department of Internal Medicine 2, Shimokato 1110, Chuo-shi, Yamanashi, 409-3898, Japan;1. Department of Respiratory Medicine and Allergology, Kindai University Faculty of Medicine, 377-2 Ohnohigashi, Osakasayama, Osaka, 589-8511, Japan;2. Kinki Hokuriku Airway Disease Conference, 377-2 Ohnohigashi, Osakasayama, Osaka, 589-8511, Japan;3. NPO Sapporo Cough Asthma and Allergy Center, Minami 4-jo Nishi 15-chome, Chuo-ku, Sapporo, 064-0804, Japan;4. Hiroshima Allergy and Respiratory Clinic, 14-7 Hatchobori, Naka-ku, Hiroshima, 730-0013, Japan |
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| Abstract: | BackgroundSpontaneous pneumomediastinum is characterized by the presence of interstitial air in the mediastinum without any underlying disease. Some cases of spontaneous pneumomediastinum have been reported in the past, although only few reports are available, and its management remains uncertain. This study reviewed our experience in the diagnosis and treatment of spontaneous pneumomediastinum.MethodsA retrospective study of 71 cases treated for spontaneous pneumomediastinum at the Yodogawa Christian Hospital between April 2005 and March 2020 was conducted.ResultsThe patients’ mean age was 19.3 years (range, 7–48 years). A triggering event was noted in 69% of the cases. Seventy-six percent of the patients were admitted to the hospital, and 24% were outpatients. Treatment included analgesia, rest, antibiotics, and/or oxygen therapy. Thirty-six patients (51%) were treated with antibiotics. None of the cases presented any complications, including mediastinitis or worsening respiratory condition. Two patients (3%) had a recurrence of spontaneous pneumomediastinum.ConclusionsAll the patients, with or without antimicrobial treatment and hospitalization, had favorable outcomes. We should therefore reconsider the need for hospitalization and antimicrobial therapy for patients with mediastinitis prophylaxis. |
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| Keywords: | Pneumomediastinum Spontaneous pneumomediastinum Mediastinal emphysema Antibiotic therapy Mediastinitis |
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