Medical Case Reports

Chronic-Vomiting Induced Recurrent Spontaneous Pneumomediastinum: Case Report

In contrast to secondary pneumomediastinum who has an identifiable cause, spontaneous pneumomediastinum is a rare clinical entity defined as the presence of free air in the mediastinal structures not associated with trauma. Its main causes are vomiting, exercise, drugs, asthma, difficult labour and valsalva maneuvers. Its classic clinical presentation is retrosternal chest pain, dyspnoea and subcutaneous emphysema. Chest X-ray or ideally a chest CT scan confirms the diagnosis. Before retaining the spontaneous character of the pneumomediastinum, several investigations should be carried out in order to detect an obvious cause such as iatrogenic or traumatic perforation of the oesophagus, trachea, or respiratory tract and intrathoracic infection. The prognosis is usually excellent without specific treatment and the recurrences are poorly described in the literature. We report the case of a 30-year-old female patient presenting dyspnoea, chest pain and facial swelling with a history of chronic vomiting over the past year and two previous episodes of similar symptomatology and who was diagnosed with recurrent spontaneous pneumomediastinum.

Author(s): Youssef Halhoul1*, Salaheddine El Miskini4, Mouaad Amraoui2, Sara Koualla3, Saad Zidouh4, Lahcen Belyamani4

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