Pneumomediastinum Cases Due To Non-Traumatic Reasons

Abstract

Aim: Pneumomediastinum due to non-traumatic reasons develops as a result of various etiologies. In this study, we aimed to compare the etiologies, clinical courses and the effectiveness of treatment modalities in pneumomediastinum cases resulting from non-traumatic reasons. Materials and methods: The data of 19 cases with non-traumatic pneumomediastinum were evaluated retrospectively between 2001 and 2008. The effectiveness of treatment methods were evaluated by arterial blood gas and pulmonary function test. The data was analyzed by SPSS (version 16.0) using Friedman test to determine the change according to the time. Pulmonary function test (SFT) parameters on first, third and seventh days were compared with two group's variance analysis (Repeated measurement ANOVA) and after variance analysis, Duncan multiple comparison test was performed to determine the different group means. In comparisons, a p value of <0.05 was considered to be statistically significant. Results: The cases consisted of 12 male and 7 female patients. The most frequent reasons of pneumomediastinum were found to be mechanical ventilation and asthma. While tracheostomy, tube thoracostomy and subcutaneous catheterization were performed in 13 of the cases, conservative approach was preferred in 6 cases. Although pulmonary function test results of the patients with subcutaneous catheter and the ones followed conservatively showed statistically significant improvement at third and seventh days compared to the initial values (p<0.05), it was noticed that the patients with subcutaneous catheter showed a faster clinical improvement. Conclusions: This study demonstrates that subcutaneous catheterization helps to improve the clinical status of the patient via rapid air decompression and tracheostomy application contribute to obtain normal ventilation by providing mediastinal decompression in cases with pneumediastinum due to the mechanic ventilation.