Pneumomediastinum
In most patients, pneumomediastinum is caused by increased pressure in the chest during extreme coughing, sneezing, vomiting, or intense physical activity.
What Is Pneumomediastinum?
Pneumomediastinum is a condition that happens when air escapes from the lungs, airways, or esophagus into the mediastinum (the space in the center of the chest where the heart is). In most patients, pneumomediastinum is caused by increased pressure in the chest during extreme coughing, sneezing, vomiting, or intense physical activity. This is called spontaneous pneumomediastinum. It is more common in teens. In some patients, pneumomediastinum can be caused by an underlying health condition.
What Are the Signs and Symptoms of Pneumomediastinum?
- Sudden chest pain
- Shortness of breath
- Swallowing hurts or is hard
- Forceful coughing
- Neck pain
What Are the Causes of Pneumomediastinum?
- Things that cause more pressure in the chest like forceful sneezing or coughing, forceful or repeated vomiting, lifting something heavy, or holding your breath
- Asthma that is not well controlled or cystic fibrosis
- An intense (traumatic) injury to the chest
- Surgery or procedures in the chest, neck, or esophagus
How Is Pneumomediastinum Diagnosed?
Pneumomediastinum is diagnosed with a chest X-ray. Other tests will be ordered if needed.
How Is Pneumomediastinum Treated?
- Most patients can manage their symptoms without going to the hospital. However, some patients may be at the hospital for observation or more tests. This is rare.
- Pain medicines, like ibuprofen (Motrin® or Advil®) or acetaminophen (Tylenol®), will be used to control pain.
- Vomiting can be controlled with medicine.
Aftercare
- Avoid high-risk activities like intense sports, scuba diving, weightlifting, and playing wind instruments for several days.
- Avoid forcing yourself to cough, scream, or cry.
- Do not smoke or use things that you would breathe in (inhale) through your nose. This includes things like cigarettes, marijuana, or cocaine.
When to Call the Doctor
Call your child’s doctor or health care provider if they have:
- A temperature of 100.8 degrees Fahrenheit (F) or 38.2 degrees Celsius (C) or higher
- Chest pain gets worse or is not getting better after taking medicines
- Shortness of breath
- Repeated, forceful vomiting
Helping Hands Patient Education Materials
Written and illustrated by medical, nursing and allied health professionals at Nationwide Children's Hospital, Helping Hand instructions are intended as a supplement to verbal instructions provided by a medical professional. The information is periodically reviewed and revised to reflect our current practice. However, Nationwide Children's Hospital is not responsible for any consequences resulting from the use or misuse of the information in the Helping Hands.
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