Spontaneous pneumomediastinum in the pediatric patient

Abstract

Background: Spontaneous pneumomediastinum (SPM) data in children are limited. We investigated the management of SPM at our institution.

Methods: We reviewed children with pneumomediastinum treated from January 2011 to October 2014. Primary (no precipitating factors) and secondary (underlying respiratory disease) SPM patients were included. Admission data and clinical outcomes were recorded.

Results: A total of 129 patients were included. Average age was 11.6 ± 4.6 years; 90 males (70%). Frequent presenting symptoms were chest pain (n = 76) and dyspnea (n = 51). Of the total, 89 patients (69%) were admitted. No patient required additional interventions. Of those, 85 patients (65.9%) had follow-up. Patients with secondary SPM (n = 58) were more likely than primary (n = 71) to be admitted (84% vs 56%, P = .001), receive oxygen (69% vs 35%, P = .04), and have longer stays (2 days [interquartile range, 1 to 3] vs 1 day [interquartile range, 0 to 1], P < .001). Readmission rates were equivalent.

Conclusions: Differentiating types of SPM is important as clinical course differs. Secondary SPM patients are more frequently admitted than primary SPM patients.

Keywords: Mediastinal emphysema; Pediatrics; Primary spontaneous pneumomediastinum; Secondary spontaneous pneumomediastinum; Spontaneous pneumomediastinum.