title: Spontaneous pneumomediastinum in the pediatric patient.
abstract: BACKGROUND
  Spontaneous pneumomediastinum (SPM) data in children are limited. We investigated the management of SPM at our institution.
  
  
  METHODS
  We reviewed children with pneumomediastinum treated from January 2011 to October 2014. Primary (no precipitating factors) and secondary (underlying respiratory disease) SPM patients were included. Admission data and clinical outcomes were recorded.
  
  
  RESULTS
  A total of 129 patients were included. Average age was 11.6 ± 4.6 years; 90 males (70%). Frequent presenting symptoms were chest pain (n = 76) and dyspnea (n = 51). Of the total, 89 patients (69%) were admitted. No patient required additional interventions. Of those, 85 patients (65.9%) had follow-up. Patients with secondary SPM (n = 58) were more likely than primary (n = 71) to be admitted (84% vs 56%, P = .001), receive oxygen (69% vs 35%, P = .04), and have longer stays (2 days [interquartile range, 1 to 3] vs 1 day [interquartile range, 0 to 1], P < .001). Readmission rates were equivalent.
  
  
  CONCLUSIONS
  Differentiating types of SPM is important as clinical course differs. Secondary SPM patients are more frequently admitted than primary SPM patients.
authors.affiliation: The Michael E. DeBakey Department of Surgery, Baylor College of Medicine, One Baylor Plaza, Houston, TX 77030, USA; Division of Pediatric Surgery, Texas Children's Hospital, 6701 Fannin Street, Suite 1210, Houston, TX 77030, USA.
authors.forename: Paulette I
authors.initials: PI
authors.lastname: Abbas
authors.affiliation: The Michael E. DeBakey Department of Surgery, Baylor College of Medicine, One Baylor Plaza, Houston, TX 77030, USA; Division of Pediatric Surgery, Texas Children's Hospital, 6701 Fannin Street, Suite 1210, Houston, TX 77030, USA.
authors.forename: Adesola C
authors.initials: AC
authors.lastname: Akinkuotu
authors.affiliation: The Michael E. DeBakey Department of Surgery, Baylor College of Medicine, One Baylor Plaza, Houston, TX 77030, USA; Division of Pediatric Surgery, Texas Children's Hospital, 6701 Fannin Street, Suite 1210, Houston, TX 77030, USA.
authors.forename: Michelle L
authors.initials: ML
authors.lastname: Peterson
authors.affiliation: The Michael E. DeBakey Department of Surgery, Baylor College of Medicine, One Baylor Plaza, Houston, TX 77030, USA; Division of Pediatric Surgery, Texas Children's Hospital, 6701 Fannin Street, Suite 1210, Houston, TX 77030, USA. Electronic address: mvmazzio@texaschildrens.org.
authors.forename: Mark V
authors.initials: MV
authors.lastname: Mazziotti
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D008478:Mediastinal Emphysema / Q000175:diagnosis* / Q000601:surgery*; D012189:Retrospective Studies
keywords: Mediastinal emphysema; Pediatrics; Primary spontaneous pneumomediastinum; Secondary spontaneous pneumomediastinum; Spontaneous pneumomediastinum