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Pneumomediastinum Complicating Diabetic Ketoacidosis and Boerhaave's Syndrome
Samer Alkhuja1, Natalya Gazizov1, Gervais Charles1
1The Commonwealth Medical College, Pocono Medical Center, 175 East Brown Street, Suite 203, East Stroudsburg, PA 18301, USA.
Abstract:
An 18-year-old man presented with altered mental status. He was found to have diabetic ketoacidosis. Chest X-ray showed pneumomediastinum. After intubation for air-way protection, an oral-gastric tube was placed. A chest computed tomography scan showed the tip of the oral-gastric tube to be in the right hemithorax. The patient underwent a thoracotomy and was managed in the intensive care unit. Both diabetic ketoacidosis and Boerhaave's syndrome should be considered as possible causes of pneumomediastinum in a patient with similar presentation. Boerhaave's syndrome should be ruled out prior to the insertion of an oral-gastric tube to avoid further morbidities.
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