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Pneumomediastinum
Aka: Pneumomediastinum
- Pathophysiology
- Spontaneous rupture of alveolus or bleb
- Results from increased pressure gradient
- Negative (Inhalation)
- Positive (Valsalva)
- Air tracks along vessels and Bronchi
- Air coalesces in mediastinum
- Causes
- Inhalation Drug Use (e.g. Huffing)
- Asthma
- Coughing
- Vomiting
- Weight lifting
- Parturition
- Symptoms
- Sore Throat
- Dyspnea
- Pleuritic Chest Pain
- Worse with lying
- Better with sitting
- Signs
- Subcutaneous Emphysema
- Hamman's crunch (50%)
- Differential Diagnosis
- Esophageal Perforation
- Tension Pneumomediastinum
- Pneumothorax
- Radiology: Chest XRay
- As many as 50% Pneumomediastinum cases missed on PA
- Review Lateral Chest XRay carefully
- Disposition
- Intensive Care Unit Admission