Spontaneous pneumomediastinum in anorexia nervosa: a case report and review of the literature on pneumomediastinum and pneumothorax.
We report a case of a 20-year-old white woman with the history of anorexia nervosa presenting with spontaneous pneumomediastinum (SPM). On admission, her body mass index (BMI) was 9.9 kg/m(2). Physical examination revealed subcutaneous crepitation especially in the axillae, the intercostal spaces, between the scapulae and along the spine. A chest X-ray showed extensive tissue emphysema, especially in the upper mediastinum. In a computed tomography (CT) scan, additional air was found in the upper retroperitoneal space adjacent to the stomach and to the left of the aorta. The patient recovered clinically within three weeks, and a CT scan showed a complete remission of the pneumomediastinum and subcutaneous emphysema. Based on this, case review of the literature about the frequency of pneumomediastinum in young patients with low weight is presented concerning epidemiology, etiology, symptoms, diagnosis, treatment, time to recovery and prognosis.
Department of General Internal and Psychosomatic Medicine, University of Heidelberg, Medical University Hospital, Im Neuenheimer Feld 410, Heidelberg, Germany. Achim_Hochlehnert@med.uni-heidelberg.de
Achim
A
Hochlehnert
Bernd
B
Löwe
Hans-Bernd
HB
Bludau
Mathias
M
Borst
Stephan
S
Zipfel
Wolfgang
W
Herzog
D000856:Anorexia Nervosa / Q000150:complications* / Q000175:diagnosis / Q000000981:diagnostic imaging; D015992:Body Mass Index; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008478:Mediastinal Emphysema / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D011030:Pneumothorax / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D012422:Rupture, Spontaneous; D014057:Tomography, X-Ray Computed; D055815:Young Adult