Tension pneumomediastinum after severe vomiting in a 21-year-old female.
A 21-year-old female with chronic membranoproliferative nephritis was admitted for suspected esophageal disruption and asthma after severe, prolonged vomiting. At the time of admission she presented with dyspnea, tachypnea, arterial hypotension and tachycardia. Physical examination showed discrete signs of ectopic air at the neck and distended cervical veins. CT-scan of the chest showed severe mediastinal emphysema with compression of the right atrium. After cervical mediastinotomy the cardiorespiratory parameters normalized immediately. Esophagoscopy showed multiple longitudinal mucosal tears between 25 and 45 cm; fluoroscopically, there was no leakage of contrast medium. Following conservative treatment the patient recovered completely and was discharged on day 8.
Gabor
Sabine Elisabeth
SE
Division of Thoracic and Hyperbaric Surgery, Department of Surgery, Medical University of Graz, Auenbruggerplatz 29, A-8036 Graz, Austria. sabine.gabor@meduni-graz.at
Renner
Heiko
H
Maier
Alfred
A
Smolle Jüttner
Freyja Maria
FM
D000208:Acute Disease; D000328:Adult; D004947:Esophagus / Q000000981:diagnostic imaging / Q000293:injuries*; D005260:Female; D015432:Glomerulonephritis, Membranoproliferative / Q000150:complications* / Q000000981:diagnostic imaging; D006801:Humans; D008478:Mediastinal Emphysema / Q000000981:diagnostic imaging / Q000209:etiology*; D014057:Tomography, X-Ray Computed; D014839:Vomiting / Q000150:complications* / Q000000981:diagnostic imaging