Tension pneumomediastinum after severe vomiting in a 21-year-old female

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 s...

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Bibliographic Details
Published in:European journal of cardio-thoracic surgery 2005-09, Vol.28 (3), p.502-503
Main Authors: Gabor, Sabine Elisabeth, Renner, Heiko, Maier, Alfred, Smolle Jüttner, Freyja Maria
Format: Article
Language:English
Subjects:
Acute Disease
Adult
Biological and medical sciences
Cardiology. Vascular system
Esophagus - diagnostic imaging
Esophagus - injuries
Female
Glomerulonephritis, Membranoproliferative - complications
Glomerulonephritis, Membranoproliferative - diagnostic imaging
Humans
Mediastinal Emphysema - diagnostic imaging
Mediastinal Emphysema - etiology
Medical sciences
Pneumology
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
Surgery of the heart
Tomography, X-Ray Computed
Vomiting - complications
Vomiting - diagnostic imaging
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Summary: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 45cm; fluoroscopically, there was no leakage of contrast medium. Following conservative treatment the patient recovered completely and was discharged on day 8.
ISSN:1010-7940
1873-734X
DOI:10.1016/j.ejcts.2005.05.015