Abstract:
A 21-year-old female with chronic membranoproliferative nephritis was admitted for suspected esophageal disruption and asthma after severe, prolonged vomiting. At the time of admission she presented with dyspnea, tachypnea, arterial hypotension and tachycardia. Physical examination showed discrete signs of ectopic air at the neck and distended cervical veins. CT-scan of the chest showed severe mediastinal emphysema with compression of the right atrium. After cervical mediastinotomy the cardiorespiratory parameters normalized immediately. Esophagoscopy showed multiple longitudinal mucosal tears between 25 and 45 cm; fluoroscopically, there was no leakage of contrast medium. Following conservative treatment the patient recovered completely and was discharged on day 8.
Gabor, Renner, Maier, Smolle Jüttner, , , , , (2005). Tension pneumomediastinum after severe vomiting in a 21-year-old female. European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery, 2005 Sep;28(3):502-3. https://www.ncbi.nlm.nih.gov/pubmed/16046264