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Spontaneous pneumomediastinum with a rare presentation
Ehsan Bolvardi1, Elham Pishbin1, Mohsen Ebrahimi1
1Department of Emergency Medicine, Mashhad University of Medical Science, Mashhad 9137913316, Iran.
Case Reports in Emergency Medicine
|June 26, 2014
Summary
Spontaneous pneumomediastinum, a rare condition often linked to intense exercise like weightlifting, can present with unusual symptoms such as hoarseness and odynophagia. This case highlights a benign outcome with conservative management.
Area of Science:
- Medicine
- Radiology
- Emergency Medicine
Background:
- Spontaneous pneumomediastinum (SPM) is the presence of air in the mediastinum, typically benign.
- While often associated with conditions like Boerhaave syndrome or respiratory disease, SPM can occur spontaneously.
- Intense physical exertion, such as weightlifting, is an uncommon trigger for SPM.
Purpose of the Study:
- To report a rare case of spontaneous pneumomediastinum following weightlifting.
- To highlight unusual presenting symptoms of hoarseness and odynophagia in SPM.
- To emphasize the effectiveness of conservative management for exercise-induced SPM.
Main Methods:
- Case report of a 20-year-old male presenting with hoarseness and odynophagia after weightlifting.
- Diagnostic workup included physical examination, chest X-ray (CXR), and cervical and chest CT.
- Treatment involved observation, oxygen therapy, and analgesics with conservative management.
Main Results:
- Imaging confirmed pneumomediastinum and subcutaneous emphysema, with air around the trachea.
- No pneumothorax or other significant complications were identified.
- Symptoms resolved within a week with conservative therapy, and the patient was discharged without complications.
Conclusions:
- Spontaneous pneumomediastinum can be triggered by intense physical exertion like weightlifting.
- Hoarseness and odynophagia are atypical but possible symptoms of SPM.
- Conservative management is effective for exercise-induced SPM, leading to favorable outcomes.
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