Pneumomediastinum is when air leaks from one lung and becomes trapped in the chest cavity, causing chest pain and shortness of breath. It can be caused by alveolar injury from coughing, laughing, or respiratory infections, as well as trauma or inhalation of harmful substances. Diagnosis is done through imaging tests and treatment depends on the severity of symptoms. Most cases heal on their own, but severe cases may require medical or surgical intervention.
Pneumomediastinum is a medical condition in which air leaks from one lung and becomes trapped in the chest cavity. It usually occurs when one of the tiny air sacs in a lung ruptures, releasing a small amount of air into the space inside the chest called the mediastinum. Depending on the amount of air escaping, pneumomediastinum can cause significant chest pain and shortness of breath. Most cases go away on their own, but a doctor may decide to manually aspirate air from the chest if symptoms are severe.
Many different factors can lead to accumulation of air in the mediastinum. The air sacs in the lungs called alveoli can become irritated and punctured from excessive pressure from a sneeze, cough or laughter. Respiratory infections and asthma can increase the chances of an alveolar injury. Additionally, direct trauma to the chest or throat can cause internal damage and lead to an air leak. Inhaling carcinogens from cigarette smoke, industrial chemicals, and dust also contributes to lung damage and rupture.
In most cases, pneumomediastinum is so mild that it causes no physical symptoms or health complications. A doctor may only notice the accumulation of air when a patient is being examined for an unrelated condition. When symptoms are present, they usually include a chronic dull ache below the breastbone, pain radiating through the chest and shoulders, and moderate difficulty breathing. If a lung collapses partially or completely, sharp pains, chest tightness, and severe shortness of breath tend to occur. An individual experiencing abnormal chest pains or trouble breathing should visit a doctor or go to the emergency room.
A doctor can check for pneumomediastinum and any underlying problems by doing a series of diagnostic imaging tests. X-rays can confirm the presence of air in the mediastinum, and computed tomography can reveal physical lung abnormalities. A doctor may also decide to take a blood sample to look at oxygen and carbon dioxide levels. Treatment decisions are made based on the amount of air present and the severity of the patient’s symptoms.
Many cases of pneumomediastinum do not require medical attention. Small alveolar or esophageal tears usually heal within a few weeks and the excess air is reabsorbed by body tissue. If pain and chest tightness are causing discomfort, a doctor may decide to insert a needle and chest tube to pull air out of the mediastinum. Surgery may be needed if a lung completely collapses to repair and reinforce damaged tissue. After medical or surgical treatment, patients are encouraged to stop smoking, exercise regularly, and schedule periodic checkups to prevent recurring lung problems.
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