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A Case Report of Spontaneous Pneumomediastinum From an Unusual Cause: Baritone Practice

Spontaneous pneumomediastinum (SPM) is a rare but potentially life-threatening clinical entity in which free air is introduced into the mediastinum. It most commonly presents in young males and has an incidence of approximately 0.002% of the general population. Symptoms include sudden onset chest pa...

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Autores principales: Meloy, Patrick, Bhambri, Amit, Emeli, Iyesatta M
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cureus 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10656280/
https://www.ncbi.nlm.nih.gov/pubmed/38021896
http://dx.doi.org/10.7759/cureus.47289
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author Meloy, Patrick
Bhambri, Amit
Emeli, Iyesatta M
author_facet Meloy, Patrick
Bhambri, Amit
Emeli, Iyesatta M
author_sort Meloy, Patrick
collection PubMed
description Spontaneous pneumomediastinum (SPM) is a rare but potentially life-threatening clinical entity in which free air is introduced into the mediastinum. It most commonly presents in young males and has an incidence of approximately 0.002% of the general population. Symptoms include sudden onset chest pain, dyspnea, neck pain, vomiting, and odynophagia. Physical examination usually reveals subcutaneous emphysema, hoarse voice, tachycardia, tachypnea, and occasionally a Hamman’s sign, which is a mediastinal “crunch” sound heard on cardiac auscultation. We present a case of an 18-year-old male baritone player who presented to the ED with chest pain and odynophagia shortly after waking up one morning. The patient’s chest radiograph (CXR) revealed free air in the mediastinum with subcutaneous air tracking into the soft tissues of the neck and supraclavicular region. CT of the chest with contrast esophagram confirmed the diagnosis of primary SPM. The cause of his condition was likely due to barotrauma secondary to playing the baritone in his marching band. He had no evidence of esophageal injury or infectious process which further supports the diagnosis of primary SPM. After an extensive workup, the patient was discharged from the ED with instructions on rest, analgesia, and antitussives as needed. Evaluation of chest pain patients in the ED should include a CXR, in addition to other indicated tests, to rule out this potentially debilitating condition. Fortunately, though SPM is potentially life-threatening, most cases resolve spontaneously without surgical intervention.
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spelling pubmed-106562802023-10-18 A Case Report of Spontaneous Pneumomediastinum From an Unusual Cause: Baritone Practice Meloy, Patrick Bhambri, Amit Emeli, Iyesatta M Cureus Cardiac/Thoracic/Vascular Surgery Spontaneous pneumomediastinum (SPM) is a rare but potentially life-threatening clinical entity in which free air is introduced into the mediastinum. It most commonly presents in young males and has an incidence of approximately 0.002% of the general population. Symptoms include sudden onset chest pain, dyspnea, neck pain, vomiting, and odynophagia. Physical examination usually reveals subcutaneous emphysema, hoarse voice, tachycardia, tachypnea, and occasionally a Hamman’s sign, which is a mediastinal “crunch” sound heard on cardiac auscultation. We present a case of an 18-year-old male baritone player who presented to the ED with chest pain and odynophagia shortly after waking up one morning. The patient’s chest radiograph (CXR) revealed free air in the mediastinum with subcutaneous air tracking into the soft tissues of the neck and supraclavicular region. CT of the chest with contrast esophagram confirmed the diagnosis of primary SPM. The cause of his condition was likely due to barotrauma secondary to playing the baritone in his marching band. He had no evidence of esophageal injury or infectious process which further supports the diagnosis of primary SPM. After an extensive workup, the patient was discharged from the ED with instructions on rest, analgesia, and antitussives as needed. Evaluation of chest pain patients in the ED should include a CXR, in addition to other indicated tests, to rule out this potentially debilitating condition. Fortunately, though SPM is potentially life-threatening, most cases resolve spontaneously without surgical intervention. Cureus 2023-10-18 /pmc/articles/PMC10656280/ /pubmed/38021896 http://dx.doi.org/10.7759/cureus.47289 Text en Copyright © 2023, Meloy et al. https://creativecommons.org/licenses/by/3.0/This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Cardiac/Thoracic/Vascular Surgery
Meloy, Patrick
Bhambri, Amit
Emeli, Iyesatta M
A Case Report of Spontaneous Pneumomediastinum From an Unusual Cause: Baritone Practice
title A Case Report of Spontaneous Pneumomediastinum From an Unusual Cause: Baritone Practice
title_full A Case Report of Spontaneous Pneumomediastinum From an Unusual Cause: Baritone Practice
title_fullStr A Case Report of Spontaneous Pneumomediastinum From an Unusual Cause: Baritone Practice
title_full_unstemmed A Case Report of Spontaneous Pneumomediastinum From an Unusual Cause: Baritone Practice
title_short A Case Report of Spontaneous Pneumomediastinum From an Unusual Cause: Baritone Practice
title_sort case report of spontaneous pneumomediastinum from an unusual cause: baritone practice
topic Cardiac/Thoracic/Vascular Surgery
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10656280/
https://www.ncbi.nlm.nih.gov/pubmed/38021896
http://dx.doi.org/10.7759/cureus.47289
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