e-ISSN: 2147-2181
CausaPedia - Hakemli Olgu Dergisi
e-ISSN: 2147-2181
CausaPedia - Hakemli Olgu Dergisi

Spontaneous Pneumodiastinum, A Rare Condition in Pediatric Asthma

Submitted : 02.08.2022 Accepted : 17.11.2022 Published: 22.11.2022

Abstract

Spontaneous pneumomediastinium is a rare condition in pediatric patients. It may originate from the trachea, esophagus or organs that may be connected to the mediastinum in the mediastinum. We present a case of pneumomediastinium with subcutaneous emphysema at the age of 4 admitted to our emergency department.
A 4-year-old male patient with known asthma was brought to the emergency department with respiratory distress. The general condition of the patient was good. Body temperature was 36.5 0 C, blood pressure was 100/60 mmHg in the right arm, pulse was 125/min, respiratory rate was 18/min, oxygen saturation value was 98. The patient's other system examinations were normal, and thoracic tomography imaging was performed due to crapitation in the neck and chest region. As a result of tomography, air densities were observed in the soft tissues in the anterior mediastinum and anterior chest wall. The patient's other system examinations were normal, and thoracic tomography imaging was performed due to crapitation in the neck and chest region. As a result of tomography, air densities were observed in the soft tissues in the anterior mediastinum and anterior chest wall. The Covid-19 polymerase chain reaction test of the patient, who did not find any abnormality in the laboratory examination, was negative. The patient was diagnosed with spontaneous pneumomediastinum due to asthma and was admitted to the intensive care unit for treatment and monitoring. Nasal oxygen support, 1 mg/kg prednol, and bronchodilator treatment were started to the patient. After 4 days of intensive care, the patient's emphysema completely regressed. The patient was discharged from the pediatric service on the 5th day.
Spontaneous pneumomediastinum, a rare condition called Hamman's syndrome, is a condition that mostly affects tall, thin adolescent males. Spontaneous pneumomediastinium, which is rare in children with asthma, may also occur due to Covid -19 disease in these days when we are experiencing the pandemic period, so it should not be forgotten in the diagnosis.
Keywords: Pneumomediastinum , Emphysema , Covid -19

Özet

Spontan pnömomediastinium pediatrik hastalarda nadir gözlenen bir durumdur. Mediastende bulunan trakea, özefagus yada mediastenle bağlantısı olabilecek organlardan kaynaklanabilir. Acil servisimize kabul edilen 4 yaşında cilt altı amfizemi bulunan pnömomediastinium olgusunu sunulmuştur.
Acil servise dış merkezden bilinen astım hastalığı olan 4 yaş erkek hasta solunum sıkıntısı ile getirildi. Hastanın genel durumu iyi vücut ısısı 36.5 0 C , kan basıncı sağ kolda 100/60 mmHg, nabzı 125/dk, solunum sayısı 18/dk oksijen saturasyon değeri 98 idi. Diğer sistem muayenleri doğal olan hastanın boyun ve göğüs bölgesinde krapitasyon olması nedeni ile toraks tomografi görüntülemesi yapıldı. Tomografi sonucunda ön mediastende ve göğüs ön duvarında yumuşak dokular içerisinde hava dansiteleri izlendi. Laboratuar incelemesinde herhangi bir anormallik rastlanmayan hastanın Covid- 19 polimeraz zincir reaksiyon testi negatif geldi. Hastaya astıma bağlı spontan pnönomomediastiniun tanısı konuldu, yakın takip ve monitörizasyon amacı ile yoğun bakıma kabul edildi. Hastaya nazal oksijen desteği,1 mg/kg prednol, bronkodilatatör tedavisi başlandı. 4 günlük yoğun bakım izlemi sonucunda hastanın amfizemi tamamen geriledi. Pediatri servisinde takibi devam edilen hasta 5.gün şifaen taburcu edildi.
Ender gözlenen Hamman’s sendromu olarak adlandırılan spontan pnömomediastinum, daha çok uzun boylu, ince yapılı adölesan erkekleri etkileyen bir durumdur. Astımlı çocuklarda nadir olan spontan pnömomediastinium, pandemi dönemini yaşadığımız bu günlerde Covid -19 hastalığına da bağlı oluşabilir bu nedenle ayrıcı tanıda unutulmamalıdır.
Anahtar kelimeler: Pnömomediastinum , Amfizem , Covid -19

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