title: Pneumomediastinum, subcutaneous emphysema, and pneumothorax after a pulmonary function testing in a patient with bleomycin-induced interstitial pneumonitis.
abstract: Spontaneous pneumomediastinum is an uncommon event, the clinical picture of which includes retrosternal chest pain, subcutaneous emphysema, dyspnea, and dysphonia. The pathophysiological mechanism involved is the emergence of a pressure gradient between the alveoli and surrounding structures, causing alveolar rupture with subsequent dissection of the peribronchovascular sheath and infiltration of the mediastinum and subcutaneous tissue with air. Known triggers include acute exacerbations of asthma and situations that require the Valsalva maneuver. We described and documented with HRCT scans the occurrence of pneumomediastinum after a patient with bleomycin-induced interstitial lung disease underwent pulmonary function testing. Although uncommon, the association between pulmonary function testing and air leak syndromes has been increasingly reported in the literature, and lung diseases, such as interstitial lung diseases, include structural changes that facilitate the occurrence of this complication.
authors: University of São Paulo, School of Medicine, Hospital das Clínicas, São Paulo, Brazil.
authors: Mariana Sponholz
authors: MS
authors: Araujo
authors: Frederico Leon Arrabal
authors: FL
authors: Fernandes
authors: Fernando Uliana
authors: FU
authors: Kay
authors: Carlos Roberto Ribeiro
authors: CR
authors: Carvalho
mesh_terms: D000903:Antibiotics, Antineoplastic / Q000009:adverse effects*; D001761:Bleomycin / Q000009:adverse effects*; D004646:Emphysema / Q000209:etiology*; D017809:Fatal Outcome; D006801:Humans; D017563:Lung Diseases, Interstitial / Q000139:chemically induced*; D008297:Male; D008875:Middle Aged; D011030:Pneumothorax / Q000209:etiology*; D012129:Respiratory Function Tests / Q000009:adverse effects*; D014057:Tomography, X-Ray Computed
chemical_list: D000903:Antibiotics, Antineoplastic; D001761:Bleomycin