title: Pneumomediastinum following esophageal rupture associated with hyperemesis gravidarum.
abstract: A patient was diagnosed with pneumomediastinum caused by an esophageal rupture during hyperemesis gravidarum. The woman, at 15 weeks' gestation, presented with hyperemesis gravidarum complicated by an episode of chest pain and disturbance of consciousness. Radiological examination revealed pneumomediastinum and subcutaneous emphysema. They are normally caused by either pulmonary or esophageal rupture. The esophageal etiology was suspected as more likely because of the severe vomiting accompanied with it. Although the clinical feature was quite complicated and esophageal rupture is generally a life-threatening disease, we chose conservative therapy which resulted in rapid recovery. The final diagnosis was confirmed by endoscopic examination performed after recovery. Pneumomediastinum during pregnancy is rare but it could be lethal. Careful and considerate assessments including surgical treatment should be necessary.
authors.affiliation: Department of Obstetrics and Gynecology, Teikyo University School of Medicine, Ichihara Hospital, Chiba, Japan. ryo@med.teikyo-u.ac.jp
authors.forename: Shan-Guang
authors.initials: SG
authors.lastname: Liang
authors.forename: Fumiko
authors.initials: F
authors.lastname: Ooka
authors.forename: Akiko
authors.initials: A
authors.lastname: Santo
authors.forename: Manabu
authors.initials: M
authors.lastname: Kaibara
mesh_terms: D000328:Adult; D004935:Esophageal Diseases / Q000150:complications / Q000209:etiology*; D005260:Female; D006801:Humans; D006939:Hyperemesis Gravidarum / Q000150:complications*; D008478:Mediastinal Emphysema / Q000209:etiology*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000209:etiology*; D012422:Rupture, Spontaneous