title: Pneumomediastinum: a rare complication of anorexia nervosa in children and adolescents. A case study and review of the literature.
abstract: Spontaneous pneumomediastinum is uncommon in paediatric practice. We describe two cases of spontaneous pneumomediastinum in a child and an adolescent with anorexia nervosa. Thorough investigation failed to reveal any underlying cause for secondary pneumomediastinum. Pneumomediastinum in anorexia nervosa can be caused by not only elevated intrathoracic pressures, but also by the poor quality of the alveolar walls due to malnutrition. The incidence of spontaneous pneumomediastinum in anorexia nervosa is probably higher than that recorded, since it resolves spontaneously and, therefore, it can remain undetected. We conclude that it is our considered opinion that malnutrition associated with anorexia nervosa predisposes for spontaneous pneumomediastinum due to weakness of the alveolar wall and the loss of connective tissue.
authors.affiliation: Department of Pediatrics, Meander Medisch Centrum Amersfoort, P.O. Box 1502, 3800 BM, Amersfoort, The Netherlands.
authors.forename: Ina
authors.initials: I
authors.lastname: van Veelen
authors.forename: Paul H G
authors.initials: PH
authors.lastname: Hogeman
authors.forename: Annemarie
authors.initials: A
authors.lastname: van Elburg
authors.forename: Fenny W
authors.initials: FW
authors.lastname: Nielsen-Abbring
authors.forename: Ben G F
authors.initials: BG
authors.lastname: Heggelman
authors.forename: Hans F
authors.initials: HF
authors.lastname: Mahieu
mesh_terms: D000293:Adolescent; D000856:Anorexia Nervosa / Q000150:complications*; D005260:Female; D006801:Humans; D008478:Mediastinal Emphysema / Q000000981:diagnostic imaging / Q000209:etiology*; D013352:Subcutaneous Emphysema / Q000000981:diagnostic imaging / Q000209:etiology*; D014057:Tomography, X-Ray Computed