Pneumomediastinum causes

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Trusha Tank, M.D.[2], Jacquelyne DiTroia

Overview

Spontaneous pneumomediastinum may be caused without any underlying pathology. Secondary pneumomediastinum may be caused by blunt or penetrating trauma to the neck, chest or abdomen. Iatrogenic causes include disruption of the airways or GI tract during endoscopic procedures, intubation/extubation, central vascular access procedure, pleural cavity instrumentation, chest or abdominal surgery. Pneumomediastinum has also been associated with: Mycoplasma pneumonia, anorexia, obesity and pulmonary barotrauma in scuba diver or an airplane passenger during rapid ascends or descends.

Causes

Spontaneous pneumomediastinum may be caused without any underlying pathology in an apparently healthy individual.

Common causes of pneumomediastinum are Iatrogenic and include:^[1]

Less common cause of pneumomediastinum is pulmonary barotrauma resulting when a person moves to or from a higher pressure environment, including:

Cardiovascular	No underlying causes
Chemical / poisoning	Inhalation of varnish fumes.
Dermatologic	No underlying causes
Drug Side Effect	Amiodarone-induced pulmonary toxicity
Ear Nose Throat	Esophageal perforation, Oesophageal rupture, Boerhaave syndrome
Endocrine	No underlying causes
Environmental	No underlying causes
Gastroenterologic	No underlying causes
Genetic	No underlying causes
Hematologic	No underlying causes
Iatrogenic	Interventions in the tracheobronchial tree or GI tract, endoscopies, intubation/extubation, thyroidectomy, tracheostomy.
Infectious Disease	No underlying causes
Musculoskeletal / Ortho	Dermatomyoscitis.
Neurologic	No underlying causes
Nutritional / Metabolic	No underlying causes
Obstetric/Gynecologic	No underlying causes
Oncologic	No underlying causes
Opthalmologic	No underlying causes
Overdose / Toxicity	No underlying causes
Psychiatric	No underlying causes
Pulmonary	No underlying causes
Renal / Electrolyte	No underlying causes
Rheum / Immune / Allergy	No underlying causes
Sexual	No underlying causes
Trauma	Blunt or penetrating truma to the chest or abdomen.
Urologic	No underlying causes
Dental	Tooth extraction
Miscellaneous	Anorexia, obesity breathing machines, ascend/descend injury during deep sea diving

References

↑ Utsumi T, Shiono H, Fukai I, Akashi A (2007). “Artificial pneumomediastinum facilitates thoracoscopic surgery in anterior mediastinum”. Interactive cardiovascular and thoracic surgery. 6 (3): 411–2. doi:10.1510/icvts.2006.147355. PMID 17669882.
↑ Tetzlaff K, Reuter M (1998). “Recurrent pulmonary barotrauma (PBT) in a previously healthy male scuba diver who suffered from repeated pneumomediastinum after shallow-water scuba dives”. Undersea Hyperb Med. 25 (2): 127–8. PMID 9670439.
↑ Jacobson FL, Loring SH, Ferrigno M (2006). “Pneumomediastinum after lung packing”. Undersea Hyperb Med. 33 (5): 313–6. PMID 17091828. Retrieved 2008-06-05.
↑ Nicol E, Davies G, Jayakumar P, Green ND (2007). “Pneumopericardium and pneumomediastinum in a passenger on a commercial flight”. Aviat Space Environ Med. 78 (4): 435–9. PMID 17484349. Retrieved 2008-06-05. Unknown parameter |month= ignored (help)
↑ Leonard, A.; Corris, P.; Parums, D.; Donaldson, L; Grant, I S; Naysmith, M R; Thomas, J S. J; Jessurun, G. A J (1997). “Amiodarone pulmonary toxicity”. BMJ. 314 (7097): 1831–1831. doi:10.1136/bmj.314.7097.1831b. ISSN 0959-8138.

Overview