Nontraumatic pneumomediastinum in children

Abstract

Summary: The aim of this study is to examine the incidence, clinical presentation and clinical course of patients with non traumatic pneumomediastinum (NTP). Subjets and methods: Descriptive retrospective analysis of the clinical records of pattients between one month and fourteen years of age admitted to our hospital with NTP in the last 13 years (1984 - 1996). Results: NTP was diagnosed in 12 of 19551 hospital admissions (0.06%). NTP was associated with asthma in 9 cases (NTPA), with pneumonia in 2 and one case was spontaneous. Subcutaneous emphysema lead to the diagnosis in only 3 cases (25%). NTP was found in 0.33% of patients admitted with a diagnosis of asthma; Their mean hospital stay was 5.4 days, while the mean stay of patients with asthma but not pneumomediastinum was 4.05 days; There were no differences in respiratory or cardiac rate, dyspnea and pulsoxymetry between the two groups. NTP resolved or improved during admission in the six cases in wich serial chest - X rays were performed. Conclusions: NTP occurs infrequently and is probably infradiagnosed, specially when associated asthma. Finding of a subcutaneous emphysema is the best predictor of NTP. Longer hospital stays in the case of NTP- A are not justified since it usually runs a benign clinical course.