Spontaneous pneumomediastinum in the pediatric patient

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• 作者：Paulette I. Abbas ; M.D.^a ; ^b ; Adesola C. Akinkuotu ; M.D.^a ; ^b ; Michelle L. Peterson ; M.S.^a ; ^b ; Mark V. Mazziotti ; M.D.^a ; ^b ; ^{mvmazzio@texaschildrens.org" class="auth_mail" title="E-mail the corresponding author}
• 关键词：Pediatrics ; Spontaneous pneumomediastinum ; Mediastinal emphysema ; Primary spontaneous pneumomediastinum ; Secondary spontaneous pneumomediastinum
• 刊名：The American Journal of Surgery
• 出版年：2015
• 出版时间：December 2015
• 年：2015
• 卷：210
• 期：6
• 页码：1031-1036
• 全文大小：161 K

文摘

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.