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Spontaneous pneumomediastinum diagnosed by the Macklin effect
Vomiting-induced pneumomediastinum is often caused by oesophageal perforation or alveolar rupture due to increased pressure. A correct diagnosis is important because both diseases have different treatments and severities. We report the case of a 21-year-old man who presented with chest pain and feve...
Autores principales: | , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Oxford University Press
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8801159/ https://www.ncbi.nlm.nih.gov/pubmed/35106132 http://dx.doi.org/10.1093/jscr/rjab634 |
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author | Kumeda, Hirotaka Saito, Gaku |
author_facet | Kumeda, Hirotaka Saito, Gaku |
author_sort | Kumeda, Hirotaka |
collection | PubMed |
description | Vomiting-induced pneumomediastinum is often caused by oesophageal perforation or alveolar rupture due to increased pressure. A correct diagnosis is important because both diseases have different treatments and severities. We report the case of a 21-year-old man who presented with chest pain and fever after frequent vomiting and had elevated white blood cell counts on blood tests. There was extensive pneumomediastinum, and the lower oesophagus was swollen and thickened on chest computed tomography. An oesophagram was not possible due to severe nausea and vomiting. Accumulation of free air was found along the peripheral bronchi or the pulmonary vascular sheath in the left lower lobe, which was continuous with the mediastinum. Based on the presence of the Macklin effect, we diagnosed a pneumomediastinum with a high possibility of spontaneous pneumomediastinum. The Macklin effect is a finding that can likely distinguish oesophageal perforation from spontaneous pneumomediastinum. |
format | Online Article Text |
id | pubmed-8801159 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Oxford University Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-88011592022-01-31 Spontaneous pneumomediastinum diagnosed by the Macklin effect Kumeda, Hirotaka Saito, Gaku J Surg Case Rep Case Report Vomiting-induced pneumomediastinum is often caused by oesophageal perforation or alveolar rupture due to increased pressure. A correct diagnosis is important because both diseases have different treatments and severities. We report the case of a 21-year-old man who presented with chest pain and fever after frequent vomiting and had elevated white blood cell counts on blood tests. There was extensive pneumomediastinum, and the lower oesophagus was swollen and thickened on chest computed tomography. An oesophagram was not possible due to severe nausea and vomiting. Accumulation of free air was found along the peripheral bronchi or the pulmonary vascular sheath in the left lower lobe, which was continuous with the mediastinum. Based on the presence of the Macklin effect, we diagnosed a pneumomediastinum with a high possibility of spontaneous pneumomediastinum. The Macklin effect is a finding that can likely distinguish oesophageal perforation from spontaneous pneumomediastinum. Oxford University Press 2022-01-30 /pmc/articles/PMC8801159/ /pubmed/35106132 http://dx.doi.org/10.1093/jscr/rjab634 Text en Published by Oxford University Press and JSCR Publishing Ltd. All rights reserved. © The Author(s) 2022. https://creativecommons.org/licenses/by-nc/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (https://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com |
spellingShingle | Case Report Kumeda, Hirotaka Saito, Gaku Spontaneous pneumomediastinum diagnosed by the Macklin effect |
title | Spontaneous pneumomediastinum diagnosed by the Macklin effect |
title_full | Spontaneous pneumomediastinum diagnosed by the Macklin effect |
title_fullStr | Spontaneous pneumomediastinum diagnosed by the Macklin effect |
title_full_unstemmed | Spontaneous pneumomediastinum diagnosed by the Macklin effect |
title_short | Spontaneous pneumomediastinum diagnosed by the Macklin effect |
title_sort | spontaneous pneumomediastinum diagnosed by the macklin effect |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8801159/ https://www.ncbi.nlm.nih.gov/pubmed/35106132 http://dx.doi.org/10.1093/jscr/rjab634 |
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