ISSN: 1305-3876
Dil: Türkçe
Hakkında: Özel sayılar şeklinde yayınlanır.
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Mediastinal Emphysema
Dr. Hadi AKAY,a Dr. Serkan ENÖNa
aGöğüs Cerrahisi AD, Ankara Üniversitesi Tıp Fakültesi, ANKARA
Mediastinal emphysema (pneumomediastinum) (PM) was firstly described by Laennec in 1819 after a traumatic injury, although spontaneous pneumomediastinum (SPM) was defined by Hamman in 1939. Even if, most of the cases are traumatic, sometimes it happens without any etiologic factor and is called spontaneous PM. In most instances, reason is pulmonary alveolar rupture related to interstitial emphysema. According to rupture, the air occurs and dissects through the perivascular, peribronchial and retroperitoneal fascial planes. As spontaneous resolution is often seen, PM is generally considered a benign process but also even if progressive and untreated, may show a fatal course. Even may be asymptomatic, dyspnea and chest pain increasing with swallowing and breathing can be seen. In physical examination, crepitation over the neck and chest wall, and Hamman’s crunch is present. For uncomplicated cases no spesific treatment is needed, spontan resolution is waited with bed rest, analgesics and avoiding Valsalva maneuvers. If the condition is serious, cyanosis, collapse, dyspnea and insufficient cardiac filling related to air compression on big vessels are present, treatment must be started rapidly. Mediastinal needle aspiration, mediastinotomy, tracheostomy or emergency thoracotomy are the teratment choices. Although, rapid surgical treatment is needed for tracheobronchial and esophageal perforations.Keywords: Pneumomediastinum, spontaneous pneumomediastinum, hamman, subcutaneous emphysemaTurkiye Klinikleri J Surg Med Sci 2006, 2(11):65-68
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