Spontaneous Pneumomediastinum in Adolescents and Children

Received 12 May 2009; accepted 1 June 2009.

Pneumomediastinum, the leakage of air or gas into the mediastinum, can be a primary or secondary diagnosis. Although spontaneous pneumomediastinum (SPM) is uncommon in pediatric respiratory disorders, it is potentially life-threatening. In this study, we investigated the associations between various etiologies and clinical presentations, hospital length-of-stay, and clinical outcomes of SPM. From January 2004 to December 2007, we collected medical records and chest films from 23 pediatric patients with SPM. Results showed that increased hospital length-of-stay was significantly associated with asthma (p = 0.035), dyspnea/tachypnea (p = 0.01), and emergent visit (p = 0.04). Dysphagia was associated with shorter hospital stay (p = 0.058). Besides, the disorder was misdiagnosed initially in 21% of patients. In conclusion, there may be close relationships between the predisposing factors of SPM and its clinical manifestations. The high rate of misdiagnosis highlights the importance of careful examination and history taking in pediatric patients with chest pain.

Key Words: asthma , chest film , spontaneous pneumomediastinum

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References

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a Division of Pediatric Cardiology and Pulmonology, Department of Pediatrics, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan

b Department of Pediatrics, Faculty of Medicine, Kaohsiung, Taiwan

c Department of Pediatrics, Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan

Address correspondence and reprint requests to: Dr Zen-Kong Dai, Department of Pediatrics, Kaohsiung Medical University Hospital, 100, Shih-Chuan 1st Road, Kaohsiung 807, Taiwan

PII: S1607-551X(10)70012-7

doi:10.1016/S1607-551X(10)70012-7

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