No abstract available.
Adolescent ; Emphysema/etiology* ; Face ; Human ; Male ; Mediastinal Emphysema/etiology ; Neck ; Peptic Ulcer Perforation/complications* ; Pneumoperitoneum/etiology ; Stomach Ulcer/complications*

Child, Preschool ; Embolism ; complications ; physiopathology ; Humans ; Male ; Mediastinal Emphysema ; etiology ; Pulmonary Atelectasis ; etiology ; Sputum ; physiology ; Subcutaneous Emphysema ; etiology

Child, Preschool ; Humans ; Influenza A Virus, H1N1 Subtype ; Influenza, Human ; complications ; virology ; Male ; Mediastinal Emphysema ; etiology ; Subcutaneous Emphysema ; etiology

OBJECTIVE: To discuss the etiology, diagnosis, treatment, and prevention of pneumomediastinum or pneumothorax during the removal of bronchial foreign bodies in children. METHODS: We analyzed the clinical data of 10 cases of pneumomediastinum or pneumothorax during the removal of bronchial foreign bodies in children. RESULTS: Two patients died and the other 8 were cured. CONCLUSION Pneumomediastinum or pneumothorax is mainly caused by the intrapulmonary hyper-pressure and fracture of pulmonary bubbles. The prognosis of pneumomediastinum or pneumothorax is closely related to such factors as correct and punctual diagnosis and quick removal of the airway obstruction.
Bronchi ; Bronchoscopy ; adverse effects ; Child, Preschool ; Female ; Foreign Bodies ; surgery ; Humans ; Infant ; Male ; Mediastinal Emphysema ; etiology ; Pneumothorax ; etiology

Pneumomediastinum and subcutaneous emphysema generally occurs following trauma to the esophagus or lung. It also occurs spontaneously in such situations of elevating intra- thoracic pressure as asthma, excessive coughing or forceful straining. We report here on the rare case of a man who experienced the signs of pneumomediastinum and subcutaneous emphysema after a prolonged bout of intractable hiccup as the initial presenting symptoms of multiple sclerosis.
Adult ; Brain/pathology ; Hiccup/*complications/etiology ; Humans ; Magnetic Resonance Imaging ; Male ; Mediastinal Emphysema/*etiology/radiography ; Multiple Sclerosis/*complications/diagnosis ; Subcutaneous Emphysema/etiology ; Thoracic Vertebrae/pathology ; Tomography, X-Ray Computed

OBJECTIVETo analyze the diagnosis, treatment and prognosis of spontaneous pneumomediastinum (SPM) in children.

METHODA retrospective analysis of the clinical data of 18 children diagnosed with SPM in Yuying Children's Hospital Affiliated to Wenzhou Medical University from December 2007 to February 2013 was performed. Information of the sequelae and recurrence of SPM was obtained by telephone follow-up. SPM was diagnosed according to Versteegh's standard. SPM cases due to mechanical ventilation, trauma, inhaled foreign body or as a result of the underlying disease were not included. Also cases of secondary pneumothorax pneumomediastinum and neonatal mediastinal emphysema were excluded.

RESULTFifteen of 18 cases were boys and 3 were girls, the range of age was from 9 to 17 years. Predisposing factors included sport activities, severe cough or without a known cause. Clinical manifestations included chest pain, chest tightness, dyspnea, neck pain, back pain, foreign body sensation or pain on swallowing, throat pain of swelling. Chest CT of 18 cases showed pneumomediastinum, 8 cases displayed varied degrees of air in neck, chest; 18 cases of SPM responded well to bed rest, oxygen, antitussive and anti-infection treatment. Fifteen cases received chest CT or X-ray inspection after therapy, showing that the pneumomediastinum disappeared or significantly absorbed, 3 cases improved in clinical symptom. Among 18 patients, telephone follow-up of 14 were successful and 4 cases were lost. An average follow-up time was (24 ± 17) months. None of the cases had any serious consequences, and recurrence happened in one case.

CONCLUSIONChildren's spontaneous pneumomediastinum is a benign disease. When a child has chest pain or chest tightness, SPM should be considered after excluding the common diseases. SPM can be diagnosed in association with clinical feature and chest CT examination. Patients respond well to conservative therapy and most of them had no severe sequelae.

Adolescent ; Chest Pain ; diagnosis ; etiology ; Child ; Dyspnea ; diagnosis ; etiology ; Female ; Follow-Up Studies ; Humans ; Male ; Mediastinal Emphysema ; complications ; diagnosis ; therapy ; Oxygen Inhalation Therapy ; Prognosis ; Radiography, Thoracic ; Recurrence ; Subcutaneous Emphysema ; diagnosis ; etiology ; Tomography, X-Ray Computed

PURPOSE: Spontaneous pneumomediastinum (SPM) is a rare entity, with only a few cases reported, especially in adolescents. We aimed to analyze the clinical characteristics of SPM in adolescents and the diagnostic implications of computed tomography (CT) and esophagography therein. MATERIALS AND METHODS: This retrospective descriptive study was conducted as a review of medical records of 416 adolescents (10-18 years of age) with chest pain from March 2005 to June 2013. Information on clinical presentation, methods of diagnosis, hospital stay, and outcomes were collected and analyzed. RESULTS: Among adolescents complaining of chest pain, 11 patients had SPM (11/416, 2.64%). All patients presented with pleuritic chest pain, and 54.5% reported neck pain as the most common associated complaint. Clinical findings were nonspecific, and initial chest X-ray assessment was diagnostic only in three of 11 patients. However, reassessment of chest X-ray revealed diagnostic findings of SPM in five of the remaining eight patients. CT was diagnostic in all patients, while esophagography and echocardiogram were uninformative. Symptomatic improvement was noted within 2.45+/-1.2 hours (range, 0.5 to 4) after supportive care; mean hospital stay was 4.54+/-0.99 days (range, 2 to 6). No recurrence was observed. CONCLUSION: SPM is a rare disease that should be considered in adolescent patients with pleuritic chest pain. Careful reading of initial chest X-rays is important to avoiding further unnecessary investigations. SPM is self-limited and treatment is supportive; nevertheless, if there are no indications of esophageal rupture, urgent esophagography is not recommended.
Adolescent ; Analgesics/*therapeutic use ; Chest Pain/diagnosis/*etiology ; Child ; Female ; Follow-Up Studies ; Humans ; Length of Stay ; Male ; Mediastinal Emphysema/complications/*diagnosis/*therapy ; Medical Records ; *Oxygen Inhalation Therapy ; Rare Diseases ; Retrospective Studies ; Risk Factors ; Tomography, X-Ray Computed ; Treatment Outcome