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A Journal on Surgery

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Chirurgia 2005 October;18(5):363-6

language: Italian

Spontaneous asymptomatic pneumomediastinum. Report of two cases

Rovera F., Dionigi G., Cadario F., Bianchi M., Perlasca F.


Pneumomediastinum or mediastinal emphysema is an uncommon condition, characterised by the pathological presence of air in the mediastinum; it is mostly due to the rupture of pulmonary alveoli. It may occur spontaneously or after trauma. Several conditions, such as asthma attacks, sneezing, violent coughing, prolonged vomiting and situations associated with greater intra-abdominal pressure are described to increase the risk of development of pneumomediastinum. Clinical presentations may be different ranging from asymptomatic cases to patients with severe respiratory impairment and emodinamic alterations. The diagnosis is based on clinical symptoms and signs and it is confirmed by the characteristic findings of the radiological examinations (chest x-rays; computed tomography of the chest). Further exams, such as bronchoscopy or esophagography, are needed in selected patients. Therapy depends on the causes and the entity of pneumomediastinum. The Authors report two cases of spontaneous asymptomatic pneumomediastinum observed in an Emergency Unit and describe the diagnostic and therapeutic strategies.

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