Spontaneous pneumomediastinum: an algorithm for diagnosis and management

• Main Authors: Kazuto Takada, Shuuichi Matsumoto, Tetsuo Hiramatsu, Eiji Kojima, Masato Shizu, Shoutarou Okachi, Kiyoko Ninomiya, Hiroshi Morioka
• Format: Article
• Language: English
• Published: SAGE Publishing 2009-12-01
• Series: Therapeutic Advances in Respiratory Disease
• Online Access: https://doi.org/10.1177/1753465809350888

Spontaneous pneumomediastinum (SPM) is a rare disorder most often affecting young males which is generally self-limiting. Despite the benign prognosis with few complications and little morbidity, it frequently confuses clinicians in primary settings, who may have difficulty differentiating SPM from other serious organ ruptures, especially oesophageal rupture (the so-called Boerhaave syndrome), which may lead to mediastinitis and may be fatal, even with appropriate interventions. An overview of adult SPM is provided, reviewing 17 studies (414 patients), including our clinical experience, and finally an algorithm for diagnosis and management of SPM is proposed, based on the characteristics of SPM.