Spontaneous pneumomediastinum in the pediatric patient
Paulette I Abbas1, Adesola C Akinkuotu1, Michelle L Peterson1
1The Michael E. DeBakey Department of Surgery, Baylor College of Medicine, One Baylor Plaza, Houston, TX 77030, USA; Division of Pediatric Surgery, Texas Children's Hospital, 6701 Fannin Street, Suite 1210, Houston, TX 77030, USA.
Background:
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.
Related Concept Videos
Pneumothorax-I
Pneumothorax can be even further classified as spontaneous, traumatic, and tension pneumothorax.
Pneumothorax-II
Clinical Manifestations:
Pneumonia I: Introduction
Risk Factors
Various factors influence the likelihood of developing pneumonia. Age plays a crucial role, with infants, children under two, and individuals over 65 at increased risk due to their...
Pulmonary Cycle: Exhalation
Pneumonia III: Complications and Assessment
Pneumonia V: Nursing management and Prevention
The nurse must practice strict medical asepsis and adhere to infection control guidelines to minimize healthcare-associated infections.
Enhance airway patency
Position the patient correctly to facilitate drainage of the affected lung segments. Manual or mechanical percussion and vibration can also be employed....


