Pneumomediastinum - Revision history

Jaketoy: /* Primary (Spontaneous) */

2024-07-11T14:57:23Z

Primary (Spontaneous)

← Revisión anterior		Revisión del 14:57 11 jul 2024
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	*Generally does not require repeat imaging, and can be managed conservatively on an outpatient basis with follow up in 24 to 48 hours<ref name="Bakhos" /><ref>Fitzwater JW, Silva NN, Knight CG, et al. Management of spontaneous pneumomediastinum in children. J Pediatr Surg. 2015 Jun;50(6):983-6. doi: 10.1016/j.jpedsurg.2015.03.024.</ref><ref>Smith BA, Ferguson DB. Disposition of spontaneous pneumomediastinum. Am J Emerg Med. 1991 May;9(3):256-9.</ref>		*Generally does not require repeat imaging, and can be managed conservatively on an outpatient basis with follow up in 24 to 48 hours<ref name="Bakhos" /><ref>Fitzwater JW, Silva NN, Knight CG, et al. Management of spontaneous pneumomediastinum in children. J Pediatr Surg. 2015 Jun;50(6):983-6. doi: 10.1016/j.jpedsurg.2015.03.024.</ref><ref>Smith BA, Ferguson DB. Disposition of spontaneous pneumomediastinum. Am J Emerg Med. 1991 May;9(3):256-9.</ref>
	*Recommend analgesia, rest, and avoidance of actions that increase pulmonary pressure (i.e. Valsalva maneuvers, etc)		*Recommend analgesia, rest, and avoidance of actions that increase pulmonary pressure (i.e. Valsalva maneuvers, etc)
	*Generally resolves within 2 weeks

	===Secondary<ref>de Virgilio C, Kim DY. Pneumomediastinum Following Blunt Trauma: Are We Closer to Unlocking Its Significance? JAMA Surg. 2015 Jun 24. doi: 10.1001/jamasurg.2015.1146.</ref>===		===Secondary<ref>de Virgilio C, Kim DY. Pneumomediastinum Following Blunt Trauma: Are We Closer to Unlocking Its Significance? JAMA Surg. 2015 Jun 24. doi: 10.1001/jamasurg.2015.1146.</ref>===

Jaketoy: /* Primary (Spontaneous) */

2024-07-11T14:55:39Z

Primary (Spontaneous)

← Revisión anterior		Revisión del 14:55 11 jul 2024
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	===Primary (Spontaneous)===		===Primary (Spontaneous)===
	*Benign and self-limited disease		*Benign and self-limited disease
	*Generally does not require repeat imaging, and can be managed conservatively on an outpatient basis<ref name="Bakhos" /><ref>Fitzwater JW, Silva NN, Knight CG, et al. Management of spontaneous pneumomediastinum in children. J Pediatr Surg. 2015 Jun;50(6):983-6. doi: 10.1016/j.jpedsurg.2015.03.024.</ref><ref>Smith BA, Ferguson DB. Disposition of spontaneous pneumomediastinum. Am J Emerg Med. 1991 May;9(3):256-9.</ref>		*Generally does not require repeat imaging, and can be managed conservatively on an outpatient basis with follow up in 24 to 48 hours<ref name="Bakhos" /><ref>Fitzwater JW, Silva NN, Knight CG, et al. Management of spontaneous pneumomediastinum in children. J Pediatr Surg. 2015 Jun;50(6):983-6. doi: 10.1016/j.jpedsurg.2015.03.024.</ref><ref>Smith BA, Ferguson DB. Disposition of spontaneous pneumomediastinum. Am J Emerg Med. 1991 May;9(3):256-9.</ref>
			*Recommend analgesia, rest, and avoidance of actions that increase pulmonary pressure (i.e. Valsalva maneuvers, etc)
			*Generally resolves within 2 weeks

	===Secondary<ref>de Virgilio C, Kim DY. Pneumomediastinum Following Blunt Trauma: Are We Closer to Unlocking Its Significance? JAMA Surg. 2015 Jun 24. doi: 10.1001/jamasurg.2015.1146.</ref>===		===Secondary<ref>de Virgilio C, Kim DY. Pneumomediastinum Following Blunt Trauma: Are We Closer to Unlocking Its Significance? JAMA Surg. 2015 Jun 24. doi: 10.1001/jamasurg.2015.1146.</ref>===

Rossdonaldson1: /* Background */

2022-04-20T22:08:46Z

Background

← Revisión anterior		Revisión del 22:08 20 abr 2022
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	==Background==		==Background==
			[[File:Body Cavities Frontal view labeled 2.jpg\|thumb\|The pericardial cavity in this image is labeled d and is part of the inferior mediastium. Here we can see its relation to the superior mediastinum a, the pleural cavities c, and the diaphragm e.]]
	[[File:Gray968.png\|thumb\|A transverse section of the thorax, showing the contents of the middle and the posterior mediastinum.]]		[[File:Gray968.png\|thumb\|A transverse section of the thorax, showing the contents of the middle and the posterior mediastinum.]]
	*Also known as mediastinal emphysema		*Also known as mediastinal emphysema

Rossdonaldson1: /* Background */

2021-04-10T12:28:40Z

Background

← Revisión anterior		Revisión del 12:28 10 abr 2021
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	==Background==		==Background==
			[[File:Gray968.png\|thumb\|A transverse section of the thorax, showing the contents of the middle and the posterior mediastinum.]]
	*Also known as mediastinal emphysema		*Also known as mediastinal emphysema
	*Definition: presence of free air in the mediastinum		*Definition: presence of free air in the mediastinum

Rossdonaldson1: /* EtiologyKouritas VK, et al. Pneumomediastinum. J Thorac Dis. 2015 Feb; 7(Suppl 1): S44–S49. doi: 10.3978/j.issn.2072-1439.2015.01.11 */

2021-02-24T19:26:01Z

EtiologyKouritas VK, et al. Pneumomediastinum. J Thorac Dis. 2015 Feb; 7(Suppl 1): S44–S49. doi: 10.3978/j.issn.2072-1439.2015.01.11

← Revisión anterior		Revisión del 19:26 24 feb 2021
Línea 19:		Línea 19:
	**Lung cancer		**Lung cancer
	**[[Foreign body in the airway]]		**[[Foreign body in the airway]]
	**[[Childbirth]]
	**[[Mycoplasma pneumoniae]] [[pneumonia]]		**[[Mycoplasma pneumoniae]] [[pneumonia]]
	**[[Influenza]] A<ref name="Niehaus" />		**[[Influenza]] A<ref name="Niehaus" />
Línea 37:		Línea 36:
	**[[Hydrocarbons\|Hydrocarbon]] inhalation		**[[Hydrocarbons\|Hydrocarbon]] inhalation
	**Bowel rupture or other cause of air in abdominal cavity (tracts up into the chest)		**Bowel rupture or other cause of air in abdominal cavity (tracts up into the chest)
			**[[Childbirth]]

	==Clinical Features==		==Clinical Features==

Rossdonaldson1: /* EtiologyKouritas VK, et al. Pneumomediastinum. J Thorac Dis. 2015 Feb; 7(Suppl 1): S44–S49. doi: 10.3978/j.issn.2072-1439.2015.01.11 */

2021-02-24T19:25:41Z

EtiologyKouritas VK, et al. Pneumomediastinum. J Thorac Dis. 2015 Feb; 7(Suppl 1): S44–S49. doi: 10.3978/j.issn.2072-1439.2015.01.11

← Revisión anterior		Revisión del 19:25 24 feb 2021
Línea 21:		Línea 21:
	**[[Childbirth]]		**[[Childbirth]]
	**[[Mycoplasma pneumoniae]] [[pneumonia]]		**[[Mycoplasma pneumoniae]] [[pneumonia]]
	**~~Excessive vomiting (i.e.,~~ [[~~Boerhaave syndrome~~]]~~, [[anorexia nervosa]])~~		**[[Influenza]] A<ref name="Niehaus" />
	**Excessive coughing (i.e., asthma exacerbation)
	**Strenuous physical activities
	*Iatrogenic		*Iatrogenic
	**Endoscopy, bronchoscopy, or colonoscopy		**Endoscopy, bronchoscopy, or colonoscopy
Línea 34:		Línea 32:
	**[[Blast injury]]		**[[Blast injury]]
	**Environmental [[pulmonary barotrauma]] (e.g. [[Scuba diving emergencies\|scuba diving]], [[Commercial in-flight medical emergencies\|flight]])		**Environmental [[pulmonary barotrauma]] (e.g. [[Scuba diving emergencies\|scuba diving]], [[Commercial in-flight medical emergencies\|flight]])
			*Other
			**Excessive vomiting (i.e., [[Boerhaave syndrome]], [[anorexia nervosa]])
			**[[Esophageal rupture]] (rare)
	**[[Hydrocarbons\|Hydrocarbon]] inhalation		**[[Hydrocarbons\|Hydrocarbon]] inhalation
	**[[Influenza]] A<ref name="Niehaus" />
	**Bowel rupture or other cause of air in abdominal cavity (tracts up into the chest)		**Bowel rupture or other cause of air in abdominal cavity (tracts up into the chest)
	**[[Esophageal rupture]] (rare)

	==Clinical Features==		==Clinical Features==

Rossdonaldson1: /* EtiologyKouritas VK, et al. Pneumomediastinum. J Thorac Dis. 2015 Feb; 7(Suppl 1): S44–S49. doi: 10.3978/j.issn.2072-1439.2015.01.11 */

2021-02-24T19:20:50Z

EtiologyKouritas VK, et al. Pneumomediastinum. J Thorac Dis. 2015 Feb; 7(Suppl 1): S44–S49. doi: 10.3978/j.issn.2072-1439.2015.01.11

← Revisión anterior		Revisión del 19:20 24 feb 2021
Línea 20:		Línea 20:
	**[[Foreign body in the airway]]		**[[Foreign body in the airway]]
	**[[Childbirth]]		**[[Childbirth]]
			**[[Mycoplasma pneumoniae]] [[pneumonia]]
	**Excessive vomiting (i.e., [[Boerhaave syndrome]], [[anorexia nervosa]])		**Excessive vomiting (i.e., [[Boerhaave syndrome]], [[anorexia nervosa]])
	**Excessive coughing (i.e., asthma exacerbation)		**Excessive coughing (i.e., asthma exacerbation)
	**Strenuous physical activities		**Strenuous physical activities
	*Iatrogenic		*Iatrogenic
	**Endoscopy		**Endoscopy, bronchoscopy, or colonoscopy
	**[[Intubation]]		**[[Intubation]]
	**Central venous access procedures		**Central venous access procedures
	**Thoracostomy		**Thoracostomy / VATS
	**Chest or abdominal surgeries		**Chest or abdominal surgeries
	*Traumatic		*Traumatic
	**~~Blunt trauma~~		**[[Thoracic trauma]] (blunt or penetrating)
	**Penetrating trauma
	**[[Blast injury]]		**[[Blast injury]]
			**Environmental [[pulmonary barotrauma]] (e.g. [[Scuba diving emergencies\|scuba diving]], [[Commercial in-flight medical emergencies\|flight]])


	**[[Hydrocarbons\|Hydrocarbon]] inhalation		**[[Hydrocarbons\|Hydrocarbon]] inhalation
	**[[Influenza]] A<ref name="Niehaus" />		**[[Influenza]] A<ref name="Niehaus" />
	**Environmental [[pulmonary barotrauma]] (e.g. [[Scuba diving emergencies\|scuba diving]], [[Commercial in-flight medical emergencies\|flight]])
	**Bowel rupture or other cause of air in abdominal cavity (tracts up into the chest)		**Bowel rupture or other cause of air in abdominal cavity (tracts up into the chest)
	**[[Mycoplasma pneumoniae]] [[pneumonia]]
	**[[Esophageal rupture]] (rare)		**[[Esophageal rupture]] (rare)
	**Iatrogenic - e.g. thoracoscopy, VATS, bronchoscopy, colonoscopy or endoscopy
	**[[Blast injury]]
	**[[Thoracic trauma]]

	==Clinical Features==		==Clinical Features==

Rossdonaldson1: /* EtiologyKouritas VK, et al. Pneumomediastinum. J Thorac Dis. 2015 Feb; 7(Suppl 1): S44–S49. doi: 10.3978/j.issn.2072-1439.2015.01.11 */

2021-02-24T18:18:42Z

EtiologyKouritas VK, et al. Pneumomediastinum. J Thorac Dis. 2015 Feb; 7(Suppl 1): S44–S49. doi: 10.3978/j.issn.2072-1439.2015.01.11

← Revisión anterior		Revisión del 18:18 24 feb 2021
Línea 18:		Línea 18:
	**Interstitial lung disease		**Interstitial lung disease
	**Lung cancer		**Lung cancer
	**Foreign body in the airway		**[[Foreign body in the airway]]
	**~~Increased intrathoracic pressure (e.g., forceful sneezing/inhalation~~ [4]		**[[Childbirth]]
	**Childbirth		**Excessive vomiting (i.e., [[Boerhaave syndrome]], [[anorexia nervosa]])
	**Excessive vomiting (i.e., Boerhaave syndrome, anorexia nervosa)
	**Excessive coughing (i.e., asthma exacerbation)		**Excessive coughing (i.e., asthma exacerbation)
	**Strenuous physical activities		**Strenuous physical activities
	*Iatrogenic		*Iatrogenic
	**Endoscopy		**Endoscopy
	**Intubation		**[[Intubation]]
	**Central venous access procedures		**Central venous access procedures
	**Thoracostomy		**Thoracostomy
Línea 33:		Línea 32:
	**Blunt trauma		**Blunt trauma
	**Penetrating trauma		**Penetrating trauma
	**Blast ~~injuries~~		**[[Blast injury]]

Rossdonaldson1: /* EtiologyKouritas VK, et al. Pneumomediastinum. J Thorac Dis. 2015 Feb; 7(Suppl 1): S44–S49. doi: 10.3978/j.issn.2072-1439.2015.01.11 */

2021-02-24T18:14:57Z

EtiologyKouritas VK, et al. Pneumomediastinum. J Thorac Dis. 2015 Feb; 7(Suppl 1): S44–S49. doi: 10.3978/j.issn.2072-1439.2015.01.11

← Revisión anterior		Revisión del 18:14 24 feb 2021
Línea 10:		Línea 10:
	*No identified cause		*No identified cause
	*Smoking or tobacco use		*Smoking or tobacco use
	*Recreational drug inhalation (cocaine, methamphetamine, marijuana, ~~ecstasy~~)		*Recreational drug inhalation ([[cocaine]], [[methamphetamine]], [[marijuana]])<ref name="Johnson">Johnson JN, Jones R, Wills BK. Spontaneous Pneumomediastinum. Western Journal of Emergency Medicine. 2008;9(4):217-218.</ref>

	====Secondary====		====Secondary====
	*Intrinsic Lung and Airway		*Intrinsic Lung and Airway
	**Asthma		**[[Asthma]] / [[COPD]] (most common co-morbidity<ref name="Bakhos" />)
	**Chronic obstructive pulmonary disease (~~COPD~~)
	**Bronchiectasis		**Bronchiectasis
	**Interstitial lung disease		**Interstitial lung disease
Línea 37:		Línea 36:


	*Primary (spontaneous) pneumomediastinum
	**[[Asthma]]/[[COPD]] (Spontaneous or secondary to forceful coughing in the setting of bronchospasm) - most common co-morbidity<ref name="Bakhos" />
	**Recreational drug use (via inhalation) - [[cocaine]], [[methamphetamine]], [[marijuana]]<ref name="Johnson">Johnson JN, Jones R, Wills BK. Spontaneous Pneumomediastinum. Western Journal of Emergency Medicine. 2008;9(4):217-218.</ref>
	**[[Hydrocarbons\|Hydrocarbon]] inhalation		**[[Hydrocarbons\|Hydrocarbon]] inhalation
	**[[Influenza]] A<ref name="Niehaus" />		**[[Influenza]] A<ref name="Niehaus" />
Línea 46:		Línea 44:
	**[[Mycoplasma pneumoniae]] [[pneumonia]]		**[[Mycoplasma pneumoniae]] [[pneumonia]]
	**[[Esophageal rupture]] (rare)		**[[Esophageal rupture]] (rare)
	*Secondary pneumomediastinum
	**Iatrogenic - e.g. thoracoscopy, VATS, bronchoscopy, colonoscopy or endoscopy		**Iatrogenic - e.g. thoracoscopy, VATS, bronchoscopy, colonoscopy or endoscopy
	**[[Blast injury]]		**[[Blast injury]]

Rossdonaldson1: /* Spontaneous (i.e. Primary) */

2021-02-24T18:05:53Z

Spontaneous (i.e. Primary)

← Revisión anterior		Revisión del 18:05 24 feb 2021
Línea 7:		Línea 7:

	===Etiology<ref>Kouritas VK, et al. Pneumomediastinum. J Thorac Dis. 2015 Feb; 7(Suppl 1): S44–S49. doi: 10.3978/j.issn.2072-1439.2015.01.11</ref>===		===Etiology<ref>Kouritas VK, et al. Pneumomediastinum. J Thorac Dis. 2015 Feb; 7(Suppl 1): S44–S49. doi: 10.3978/j.issn.2072-1439.2015.01.11</ref>===
	====~~Spontaneous~~ (i.e. ~~Primary~~)====		====Primary (i.e. Spontaneous)====
	*No identified cause		*No identified cause
	*Smoking or tobacco use		*Smoking or tobacco use