Oesophagography and oesophagoscopy are not necessary in patients with spontaneous pneumomediastinum.
BACKGROUND
Because the condition is rare, the proper assessment of spontaneous pneumomediastinum (SPM) remains controversial. The purpose of this study was to determine whether additional oesophageal investigations beyond chest x ray and chest computed tomography (CT) scan are necessary for the diagnosis of SPM.


METHODS
The medical records of 25 patients diagnosed and treated for SPM from March 1986 to December 2007 were retrospectively reviewed.


RESULTS
There were 22 men and 3 women, with a median age of 19 years (range 15-57 years). All patients received chest x rays, which revealed air shadows within the mediastinum or subcutaneous emphysema in 24 patients. Twenty-two patients underwent chest CT scans, which showed pneumomediastinum in all cases. Oesophagography was performed in 14 patients and oesophagoscopy in three. All oesophagographies and oesophagoscopies were clear. Despite conservative treatment, no patients developed mediastinitis or complications associated with oesophageal injury.


CONCLUSIONS
Chest x ray and CT scan are sufficient to diagnose SPM. Additional diagnostic assessments such as oesophagography and oesophagoscopy are not necessary in patients without evidence of mediastinitis or a history of oesophageal injury.
Haam
S J
SJ
134 Sinchon-dong, Seodaemun-gu, CPO Box 8044, Seoul 120-752, South Korea; ik2653@yuhs.ac.
Lee
J G
JG
Kim
D J
DJ
Chung
K Y
KY
Park
I K
IK
D000293:Adolescent; D000328:Adult; D004945:Esophagoscopy; D005260:Female; D006801:Humans; D008297:Male; D008478:Mediastinal Emphysema / Q000175:diagnosis* / Q000000981:diagnostic imaging; D008875:Middle Aged; D012189:Retrospective Studies; D013352:Subcutaneous Emphysema / Q000175:diagnosis* / Q000000981:diagnostic imaging; D014057:Tomography, X-Ray Computed; D055815:Young Adult