Research Information System
12TH INTERCONTINENTAL EMERGENCY MEDICINE CONGRESS &12TH INTERNATIONAL CRITICAL CARE AND EMERGENCY MEDICINE CONGRESS, Antalya, Turkey, 17 - 20 April 2025, pp.73-74, (Full Text)
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A Rare Complication of Upper Respiratory Tract Infection in the Emergency Department: Pneumomediastinum
Mehmed ULU1 , Abdil Coskun2 , murtaza kaya2
1Adiyaman Research and Training Hospital Emergency Department
2Kutahya Health Sciences University Medical Faculty Emergency Medicine Department
Introduction Spontaneous pneumomediastinum (SPM) is a rare condition caused by free air accumulation in the mediastinum without trauma or iatrogenic etiology. This condition is usually seen in young men typically occurs due to increased intrathoracic pressure from severe coughing, exacarbation of asthma, vomiting, or physical exertion (1,2). It is mainly caused by alveolar rupture due to increased intraalveolar pressure and air travelling along the bronchovascular sheath into the mediastinum. While SPM is mostly benign and self-limited, it must be differentiated from life-threatening conditions like acute coronary sendrom, pneumothorax, esophageal rupture, mediastinitis (3,4). This case report aims to discuss a case of spontaneous pneumomediastinum in a previously healthy young woman, focusing on the clinical approach, diagnostic evaluation, and management.
Case A 19-year-old female patient with no history of chronic illness presented to emergency department (ED) with sore throat, cough, and sharp chest pain. Despite prior emergency visits and treatment for upper respiratory tract infection, her symptoms persisted. Vital signs were within normal limits. On physical examination, oropharyngeal hyperemia was noted, pulmonary auscultation was unremarkable, and no pathological findings were detected in other systemic evaluations. The patient reported a 3–4-day history of symptoms, during which she presented twice to an external ED. Despite medical treatment, her complaints persisted, and her chest pain gradually intensified. Due to repeated emergency department visits, laboratory tests were performed, revealing a white blood cell (WBC) count of 15,000 and a neutrophil count of 13,000, with no abnormalities noted in other external laboratory results. The patient's electrocardiogram (ECG) was consistent with normal sinus rhythm. Thoracic computed tomography (CT) revealed pneumomediastinum (Figure 1). A consultation with the thoracic surgery department was obtained, and the patient was admitted to the surgical ward. After four days of inpatient follow-up, her symptoms improved, and she was discharged in good condition with a prescription.
Conclussion Although pneumomediastinum generally has a favorable prognosis, it can be complicated by life-threatening conditions such as pneumothorax, subcutaneous emphysema, mediastinitis, tension pneumomediastinum, and air embolism. Clinicians should consider SPM in patients with persistent chest pain and upper respiratory tract infection symptoms. Keywords: Pneumomediastinum, chest pain, upper respiratory tract infection
References
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