Source: Annual Congress 2008 - Mediastinal lesions; rare pathology
Disease area: Paediatric lung diseases

Abstract

Introduction: Spontaneous pneumomediastinum (SPM) is a frequently rare entity and commonly seen in asthmatic patients. Generally, SPM occurs after the first decade of life dominantly with the contribution of violent coughing. Epidural pneumatosis (EP) is an extremely rare event occurs as the complication of pneumomediastinum in which air diffuses freely to the epidural space.
Aims and Objective: We report two cases of SPM associated with EP occured after non-violent coughing during a common cold in two children aged 6 and 9 years. Awareness of this rare condition is emphasized and treatment strategies are discussed.
Case 1: A 6-year-old girl presented with pain, widespread swelling and crepitation involving the neck, axilla, chin, back and chest associated with dysphonia. Cervical and thorax CT revealed diffuse mediastinal emphysema associated with EP. After a conservative approach her status improved. Emphysema dissappeared on the 10^th day and she was discharged without any problem.
Case 2: A 9-year-old girl presented with pain and swelling involving the back and neck occured acutely during an epizode of fever and mild coughing. Thorax CT depicted widespread mediastinal and a small opasity on the right paracardiac zone. She was discharged after a 12-day conservative approach with both clinical and radiological improvement.
Conclusion: The cases presented highlight the benign course of SPM once again even with the presence of EP. However, a full-monitoring and evaluation is mandatory in such a rare condition in order to exclude other serious aetiologies.

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Citations should be made in the following way:
H. Turut, E. Guler, N. Okur, M. Davutoglu, H. Karabiber (Kahramanmaras, Turkey). Spontaneous pneumomediastinum associated with epidural pneumatosis: report of two cases in the first decade of life. Eur Respir J 2008; 32: Suppl. 52, 2142

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