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[Macklin effect in pediatric spontaneous pneumomediastinum]
Manuel D Bilkis1, Ezequiel Monteverde
1UTIP, Sanatorio Mater Dei, Buenos Aires. mbilkis@gmail.com
Archivos Argentinos De Pediatria
|May 15, 2010
Summary
Spontaneous pneumomediastinum, air in the chest cavity, occurred in a child after severe coughing. This rare pediatric case highlights the Macklin effect, air spreading via the perivasculobronchial sheath.
Area of Science:
- Pediatric Medicine
- Radiology
- Thoracic Surgery
Background:
- Pneumomediastinum involves air in the mediastinum, often linked to trauma or spontaneous causes.
- Spontaneous pneumomediastinum is uncommon in children, typically resolving without intervention.
Observation:
- A four-year-old child presented with spontaneous pneumomediastinum following a forceful cough, likely from a common cold.
- Clinical signs included neck pain, swelling, and crepitus, prompting pediatric admission and diagnostic imaging.
Findings:
- Chest and neck X-rays confirmed pneumomediastinum.
- CT scan revealed air migration via the perivasculobronchial sheath into the mediastinum, consistent with the Macklin effect.
- This represents the first reported pediatric case of spontaneous pneumomediastinum attributed to the Macklin effect.
Implications:
- This case expands the understanding of spontaneous pneumomediastinum in pediatric populations.
- It underscores the importance of recognizing the Macklin effect as a mechanism for air entry into the mediastinum.
- The findings suggest that even severe coughing can precipitate this condition, emphasizing the need for accurate diagnosis and appropriate management.
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