title: Diagnosis and treatment of spontaneous pneumomediastinum: experience at a single institution for 10 years.
abstract: OBJECTIVE
  The aim of this study was to identify appropriate method of diagnosis and treatment of spontaneous pneumomediastinum (SPM) based on our experience.
  
  
  METHODS
  The medical records of patients who were diagnosed with SPM and treated at our hospital between April 2006 and July 2015 were, retrospectively, analyzed. The data included characteristics of the patients, method of diagnosis, treatment and clinical course.
  
  
  RESULTS
  Forty-five patients were diagnosed with SPM and treated at our hospital. The mean age of patients was 18.96 ± 4.65 years and 35 patients were male. The main symptoms expressed by these patients were chest pain, throat pain or discomfort, and dyspnea. Nine patients had a precipitating event leading to SPM. Twelve patients had normal chest X-ray findings but were subsequently diagnosed with SPM on chest computed tomography (CT). Additional procedures including esophagogram (n = 36), bronchoscopy (n = 14) and endoscopy (n = 1) were done but none of patients were found to have organ damage. All patients received oxygen inhalation therapy. Oral intake was restricted in 36 patients and 43 patients received prophylactic antibiotics. The mean time taken for symptomatic improvement was 1.73 ± 0.85 days from diagnosis. The mean hospital stay was 3.93 ± 1.44 days and no patient developed recurrence of SPM during the follow-up period.
  
  
  CONCLUSIONS
  In addition to chest X-ray, chest CT is recommended for accurate diagnosis of SPM. However, further invasive investigations, restriction of oral intake and the use of prophylactic antibiotics have minimal role in the diagnosis and treatment of SPM.
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Soonchunhyang University, Cheonan Hospital, 31, 6-gil, Soonchunhyang, Dongnam-gu, Chenan-si, Chungcheongnam-do, Cheonan, 31151, South Korea. magicwizard@hanmail.net.
authors.forename: In-Hag
authors.identifier: http://orcid.org/0000-0001-9181-017X
authors.initials: IH
authors.lastname: Song
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Soonchunhyang University, Cheonan Hospital, 31, 6-gil, Soonchunhyang, Dongnam-gu, Chenan-si, Chungcheongnam-do, Cheonan, 31151, South Korea.
authors.forename: Seock Yeol
authors.initials: SY
authors.lastname: Lee
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Soonchunhyang University, Cheonan Hospital, 31, 6-gil, Soonchunhyang, Dongnam-gu, Chenan-si, Chungcheongnam-do, Cheonan, 31151, South Korea.
authors.forename: Seung Jin
authors.initials: SJ
authors.lastname: Lee
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Eulji University Hospital, Daejeon, South Korea.
authors.forename: Won Suk
authors.initials: WS
authors.lastname: Choi
mesh_terms: D000293:Adolescent; D000328:Adult; D001999:Bronchoscopy / Q000379:methods*; D003937:Diagnosis, Differential; D005260:Female; D005544:Forecasting; D006801:Humans; D007902:Length of Stay / Q000639:trends; D008297:Male; D008478:Mediastinal Emphysema / Q000175:diagnosis* / Q000628:therapy*; D010102:Oxygen Inhalation Therapy / Q000379:methods*; D013902:Radiography, Thoracic; D012008:Recurrence; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods*; D055815:Young Adult
keywords: Diagnosis; Pneumomedistinum; Spontaneous; Treatment