SPONTANEOUS MEDIASTINAL EMPHYSEMA AND SPONTANEOUS PNEUMOTHORAX—A REPORT OF 20 CASES

Publisher Website
Google Scholar
Abstract
Spontaneous pneumothorax is not an unusual occurrence although the actual incidence is difficult to estimate. Mediastinal emphysema is no longer regarded as a medical rarity. The usual explanation for the production of mediastinal emphysema is that the source of air is from a ruptured alveolus or alveoli. From this site within the lung the air dissects along the perivascular sheath to the mediastinum. The air then ruptures through the mediastinal pleura with the production of a pneumothorax. The frequency of pneumothorax associated with pneumomediastinum would indicate that this is the usual mode of production of the so-called spontaneous pneumothorax. In a 4-yr. period 20 individuals with pneumothorax and pneumomediastinum have been observed among the students of the University of Wisconsin. Of these 20 individuals, there were 6 pneumothoraces without recognized pneumomediastinum, 7 mediastinal emphysemas without demonstrable pneumothorax and 7 in whom the 2 conditions Were associated. The usual course of these condi-tions is benign and no serious complications have been noted. The treatment is symptomatic. For dyspnoea associated with pneumothorax, the most effective therapy is the prompt removal of air from the pleural space.