Spontaneous pneumomediastinum and pneumopericardium in a young male with asthma.

INTRODUCTION: Spontaneous pneumomediastinum with pneumopericardium is an uncommon clinical entity. CASE STUDY: Here, we report the case of a 23-year-old male with asthma who presented with acute chest pain and shortness of breath after an episode of coughing and sneezing. CT scans of the chest and neck revealed pneumomediastinum and pneumopericardium with extensive subcutaneous emphysema extending into the axilla and neck. RESULTS: The patient was admitted for observation and analgesia. No other interventions were administered. Interval scans performed on day five of the admission demonstrated an interval reduction in the degree of air within the mediastinum, pericardium and subcutaneous tissues, and the patient was subsequently discharged home. CONCLUSION: This case outlines the presentation, diagnosis, and management of concurrent spontaneous pneumomediastinum and pneumopericardium.

Cycling-induced recurrent spontaneous pneumomediastinum and pneumopericardium in a young female patient.

We present an exceptional case of recurrent cycling-induced spontaneous pneumomediastinum and pneumopericardium in a female patient without any trauma. Radiological and endoscopic examinations were carried out to exclude other differential diagnoses. Decision for in-hospital observation and conservative treatment was made. No symptoms were reported 12 months after return to sports activity.

Brugada phenocopy or congenital Brugada syndrome in a patient with spontaneous pneumopericardium and pericarditis.

Brugada syndrome (BrS) is characterized by coved ST segment elevation in the right precordial lead (V1-V3). Previous reports have described type-1 or type-2 Brugada ECG pattern as a Brugada phenocopy (BrP) in various clinical condition and once the etiology is resolved, the BrP ECG pattern normalizes. We describe a case report of type-1 Brugada ECG pattern in a patient with acquired immunodeficiency syndrome (AIDS) and active pulmonary tuberculosis, which developed to spontaneous pneumopericardium and pericarditis. The coexistence of type-1 Brugada ECG pattern with spontaneous pneumopericardium and pericarditis is an extremely rare pathological condition that has not been previously described.

Spontaneous pneumomediastinum, pneumopericardium, pneumothorax and subcutaneous emphysema in patients with COVID-19 pneumonia, a case report.

BACKGROUND: Spontaneous pneumomediastinum unrelated to mechanical ventilation is a newly described complication of COVID-19 pneumonia. The objective of this case presentation is to highlight an important complication and to explore potential predisposing risk factors and possible underlying pathophysiology of this phenomenon. CASE PRESENTATION: We present two patients with COVID-19 pneumonia complicated by spontaneous pneumomediastinum, pneumopericardium, pneumothorax and subcutaneous emphysema without positive pressure ventilation. Both patients had multiple comorbidities, received a combination of antibiotics, steroids and supportive oxygen therapy, and underwent routine laboratory workup. Both patients then developed spontaneous pneumomediastinum and ultimately required intubation and mechanical ventilation, which proved to be challenging to manage. CONCLUSIONS: Spontaneous pneumomediastinum is a serious complication of COVID-19 pneumonia, of which clinicians should be aware. Further studies are needed to determine risk factors and laboratory data predictive of development of spontaneous pneumomediastinum in COVID-19 pneumonia.

Pneumomediastinum and pneumopericardium 11 days after Whipple procedure. A case report and review if the literature.

INTRODUCTION: Spontaneous pneumomediastinum (SPM) is a rare condition classified as free air in the mediastinum in the absence of any precipitating cause. This is the first time that a synchronous presence of pneumopericardium is described. To date, there are no clear guidelines for diagnosis and treatment. PRESENTATION OF A CASE: A 34-year old Caucasian male patient presented to our institution with a recently diagnosed pancreatic adenocarcinoma. He underwent an uneventful pancreaticoduodenectomy (Whipple procedure). Preoperative and intraoperative chest X-Ray after a central line placement were normal. The postoperative course was uneventful, but few hours before his discharge he presented an acute tachycardia and tachypnea with hypocapnia and a transient loss of consciousness. The full-body CT scan revealed a pneumomediastinum and pneumopericardium without any findings of anastomotic leak or other pathology from the abdomen. A meticulous review of the literature was conducted about the pathophysiology, treatment options and outcomes of pneumomediastinum after a surgical procedure. DISCUSSION: This is the first study presenting the case of spontaneous pneumomediastinum with a synchronous pneumopericardium in the literature as a late complication of Whipple procedure. The applied diagnostic algorithm and conservative treatment are presented to extend our limited knowledge about this rare medical entity. CONCLUSION: Awareness of these medical entities is important for the adequate management and optimal outcome of patients presenting a spontaneous pneumomediastinum. As such, all cases, treatment decisions and outcomes should be reported.