Spontaneous pneumomediastinum: diagnostic and therapeutic interventions.
OBJECTIVE
The objective of this case series is to review our experience with spontaneous pneumomediastinum, review the available literature, and refine the current clinical approach to this uncommon condition.


METHODS
The case notes of all patients admitted to the George Washington University Medical Center with spontaneous pneumomediastinum from April 2005 to June 2008 were retrospectively reviewed, indentifying seventeen patients on whom various data was collected and analyzed.


RESULTS
The typical patient is a young man. The commonest presenting complaint is chest pain. Odynophagia and subcutaneous emphysema are common. Leucocytosis is uncommon. The need for swallow studies, antibiotics, and prolonged hospitalization is uncommon. Most patients have no recurrences or sequelae on long-term follow-up.


CONCLUSIONS
Spontaneous pneumomediastinum is an uncommon, self-limiting condition. Due to concerns for the integrity of the aero-digestive tract, the finding of spontaneous pneumomediastinum usually results in unnecessary radiological investigations, dietary restriction and antibiotic administration with prolonged hospitalization.
Al-Mufarrej
Faisal
F
George Washington University Medical Center, Department of Surgery, Washington, DC 20037, USA. faisalmiam@gmail.com
Badar
Jehangir
J
Gharagozloo
Farid
F
Tempesta
Barbara
B
Strother
Eric
E
Margolis
Marc
M
D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001416:Back Pain / Q000209:etiology; D002637:Chest Pain / Q000209:etiology; D003680:Deglutition Disorders / Q000209:etiology; D004417:Dyspnea / Q000209:etiology; D005260:Female; D005334:Fever / Q000209:etiology; D005338:Fibrin Fibrinogen Degradation Products / Q000032:analysis; D006801:Humans; D007958:Leukocyte Count; D008297:Male; D008478:Mediastinal Emphysema / Q000175:diagnosis* / Q000628:therapy*; D009325:Nausea / Q000209:etiology; D012189:Retrospective Studies; D013352:Subcutaneous Emphysema / Q000209:etiology; D055815:Young Adult
D000900:Anti-Bacterial Agents; D005338:Fibrin Fibrinogen Degradation Products; C036309:fibrin fragment D