Spontaneous pneumomediastinum: A single centre 19 years review

9^th International Congress on Surgery

August 27-28, 2018 Tokyo, Japan

Leung Wan Chi

Tuen Mun Hospital, Hong Kong

Scientific Tracks Abstracts: Surgery

Abstract :

Spontaneous Pneumo-Mediastinum (SPM) is a rare and benign disorder. The aim of this study is to review its clinical presentation, natural course, diagnostic workup, management and prognosis. From July 1999 to August 2017, total 89 patients diagnosed with SPM were reviewed, retrospectively. The mean age was 22.0±14.2 years old and 72 (80.9%) were male. Chest pain (58, 65.2%) was the most common presentation. The most frequent predisposing factor was smoker (18, 20.2%) yet the majority (32, 36%) had none. Although cough (20, 22.5%) was the most common precipitating factor, the majority (33, 37.1%) had none. Chest XR (Positive Predictive Value (PPV) 90.8%) was diagnostic in most patients while thoracic Computed Tomography (CT) (PPV 100%) was in all cases. Oesophago-Gastro-Duodenoscopy (OGD) (20, 22.5%), flexible laryngoscopy (1, 1.1%) and water-soluble contrast swallow (30, 33.7%) were done selectively according to clinical or CT suspicion. All patients were admitted and most of them (88, 98.9%) were managed conservatively. Only 8 patients (10%) suffered from SPM-related complications and 5 patients (5.6%) required Intensive Care Unit transfer. The mean length of hospitalization was 4.3±7.6 days. No recurrence was noted except 1 patient presented with the second episode during current study. 3 patients (3.4%) died eventually due to underlying disease progression. Uncomplicated SPM favors a benign course and responds well to conservative management. Invasive investigation and aggressive treatment are reserved in selected cases. A short period of hospitalization is enough for completion of workup and patients can be subsequently discharged and followed up in outpatient clinic instead.

Biography :

Leung Wan Chi is a Resident in Tuen Mun Hospital, Hong Kong. She has completed her undergraduate studies from Li Ka Shing Faculty of Medicine, the University of Hong Kong. Her research studies are on pneumomediastinum.

E-mail: wanchi_leung@yahoo.com.hk