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Medical causes of pneumomediastinum in children

D T Damore1, P S Dayan

  • 1Pediatric Emergency Medicine, Children's Hospital Medical Center of Akron, Ohio, USA.

Clinical Pediatrics
|March 23, 2001
PubMed

Insights

Pneumomediastinum in children is uncommon, often caused by asthma or infections. Key signs include subcutaneous emphysema and sore throat, with pneumothorax as a potential complication.

Area of Science:

  • Pediatric Medicine
  • Pulmonology
  • Medical Diagnostics

Background:

  • Pneumomediastinum, the presence of air in the mediastinum, can occur in children due to various medical conditions.
  • Understanding its causes, clinical presentation, and complications is crucial for appropriate management.

Purpose of the Study:

  • To investigate the medical causes, clinical findings, and associated complications of pneumomediastinum in pediatric patients.
  • To analyze the prevalence of pneumomediastinum in relation to specific conditions like asthma and foreign body ingestions.

Main Methods:

  • Retrospective review of medical records (1985-1994) at a children's hospital.
  • Inclusion criteria focused on non-traumatic, non-iatrogenic medical causes, excluding neonates and patients with procedures.
  • International Classification of Diseases, ninth revision (ICD-9) codes were used to identify cases.

Main Results:

  • Twenty-nine pediatric cases of pneumomediastinum were identified, with asthma exacerbations (59%) and infections (28%) being the most common causes.
  • Subcutaneous emphysema (76%), sore throat/neck pain (38%), and Hamman's crunch (10%) were the most frequent clinical findings.
  • Pneumothorax was the primary complication, observed in 7% of patients, including one tension pneumothorax in a recurrent case.

Conclusions:

  • Pneumomediastinum is an infrequent condition in children, predominantly linked to asthma and infections.
  • Clinical presentation commonly involves subcutaneous emphysema and neck pain; pneumothorax is the main complication.
  • The clinical significance lies in identifying underlying causes and potential severe complications, impacting hospital stay duration.

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