급성천식에서 발생한 자발성 종격동기종 = A Case of Spontaneous Pneumomediastinum during an Acute Asthma Attack

다국어 초록 (Multilingual Abstract)

Spontaneous pneumomediastinum is a rare complication of asthma. During acute attack of asthma alveolar overdistension or rupture due to excessive air pressure results in the leakage of air from the respiratory tract and through dissection along great vessel sheaths to the mediastinum and pericardium. The clinical diagnosis is based on the symptom triads of chest pain, dyspnea, and subcutaneous emphysema, and is also based on Hamman`s sign. The diagnosis is confirmed by chest radiography. The main differential diagnosis is esophageal perforation, which requires esophagography with contrast when there is the slightest doubt in the diagnosis. Management consists of eradication of the underlying cause, rest, analgesics, and simple clinical monitoring. Predisposing factors should be identified and managed to prevent recurrence. We report a case of subcutaneous emphysema in a 15-year-old patient with asthma who presented with spontaneous pneumomediastinum and pneumopericardium. (Korean J Asthma Allergy Clin Immunol 2006;26:310-313)