Pneumomediastinum is defined as air in the middle of the chest (mediastinum). Take note that the mediastinum rests amidst the lungs which includes the thymus gland, heart and a section of the trachea and esophagus. Air might end up trapped in this region.
The air can enter the mediastinum from an injury or leaking in the lungs, esophagus or trachea.
What are the causes?
Pneumomediastinum can develop if pressure increases in the lungs and causes the alveoli to rupture. It is likely due to damage to the lungs or adjacent structures that enable the leakage of air into the center of the chest.
Some of the usual causes include:
- Chest injuries
- Tear in the lungs or esophagus from an injury or surgical procedure
- Surgery to the chest, neck or upper abdomen
The chief sign of pneumomediastinum is chest pain that can arise abruptly and might be serious. - Activities that place pressure on the lungs such as childbirth or strenuous exercise
- Rapid change in the air pressure such as rapid ascent while scuba diving
- Conditions that causes intense coughing such as lung infections or asthma
- Using a breathing machine
- Using inhaled drugs such as marijuana or cocaine
- Vomiting
- Chest infections such as tuberculosis
- Conditions that cause lung scarring
- Valsalva maneuver
What are the indications?
The chief sign of pneumomediastinum is chest pain that can arise abruptly and might be serious.
Other signs that might be present include:
- Coughing
- Shortness of breath
- Labored or shallow breathing
- Vomiting
- Neck pain
- Difficulty swallowing
- Hoarse voice
- Presence of air beneath the skin of the chest
When assessed by a doctor, there is a crunching sound heard with the heartbeat while listening to the chest using a stethoscope.
Management of pneumomediastinum
It is important to note that pneumomediastinum is not generally serious. The air is sooner or later reabsorbed by the body. The aim of treatment is to properly manage the symptoms.
In most cases, an overnight stay in a hospital is necessary for monitoring. After this period, the treatment includes:
- Pain medications
- Bed rest
- Cough medications
- Anti-anxiety drugs
- Antibiotics if infection is present
Some individuals require oxygen to breathe. It also helps hasten the reabsorption of air in the mediastinum.
Any condition that resulted to the buildup of air such as a lung infection or asthma requires treatment.