Pulmonology Book

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Pneumomediastinum

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  1. Pathophysiology
    1. Spontaneous rupture of alveolus or bleb
    2. Results from increased pressure gradient
      1. Negative (Inhalation)
      2. Positive (Valsalva)
    3. Air tracks along vessels and bronchi
    4. Air coalesces in mediastinum
  2. Causes
    1. Inhalation Drug Use (e.g. Huffing)
    2. Asthma
    3. Coughing
    4. Vomiting
    5. Weight lifting
    6. Parturition
  3. Symptoms
    1. Sore Throat
    2. Dyspnea
    3. Pleuritic Chest Pain
      1. Worse with lying
      2. Better with sitting
  4. Signs
    1. Subcutaneous Emphysema
    2. Hamman's crunch (50%)
  5. Differential Diagnosis
    1. Esophageal Perforation
    2. Tension Pneumomediastinum
    3. Pneumothorax
  6. Radiology: Chest XRay
    1. As many as 50% pneumomediastinum cases missed on PA
    2. Review Lateral Chest XRay carefully
  7. Disposition
    1. Intensive Care Unit Admission

Mediastinal Emphysema (C0025062)

Definition (MSH)Presence of air in the mediastinal tissues due to leakage of air from the tracheobronchial tree, usually as a result of trauma.
ConceptsPathologic Function (T046)
ICD9518.1
MSHD008478
EnglishMediastinal Emphysema, Mediastinal Emphysemas, Pmeumomediastinum, Pneumomediastinum
Spanishenfisema del mediastino, enfisema mediastinal, enfisema mediastinico, neumomediastino
Parent ConceptsPathological accumulation of air in tissues (C0013990), Mediastinal Diseases (C0025061), Ambiguous concept (C1274012), Duplicate concept (C1274013)
SourcesCOSTAR, DXP, LCH, MSH, MTHICD9, NDFRT, SCTSPA, SNOMEDCT
Derived from the NIH UMLS (Unified Medical Language System)



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