SESSION TITLE: Interstitial Lung Disease Global Case Reports
SESSION TYPE: Global Case Report
PRESENTED ON: Tuesday, October 29, 2013 at 01:30 PM - 02:30 PM
INTRODUCTION: In this report we describe a case of a patient with underlying pulmonary fibrosis presenting with sudden onset chest pain and found to have pneumomediastinum on computed tomography (CT) and the symptoms gradually diminished with the use of high concentration oxygen therapy .
CASE PRESENTATION: A 50 yrs old female admitted in our hospital with complaints of dry cough and dyspnoea on exertion for last two years. After thorough clinical workup, a diagnosis of interstitial pulmonary fibrosis was made. Patient was put on low dose oral steroids and was discharged after few days under satisfactory conditions. Two weeks later, she presented to the hospital again with chief complaints of sudden onset chest pain and increasing shortness of breath. On clinical examination, subcutaneous emphysema of the neck was noted. High resolution CT chest revealed pneumomediastinum along with subcutaneous emphysema of the neck and anterior chest wall. Patient managed with conservative treatment for pneumomediastinum and her clinical condition improved gradually.
DISCUSSION: Pneumomediastinum is the presence of air in the mediastinum. The disorder occurs spontaneously due to a predisposing lung disease, trauma or surgical procedure. (1)
CONCLUSIONS: It is important to consider pneumomediastinum as a potential cause of shortness of breath in patients with history of lung disease, particularly interstitial lung disease and to distinguish its symptoms from similar clinical findings that require immediate treatment because when spontaneous pneumomediastinum is positively diagnosed, only conservative treatment is required.
Reference #1: Thomas E. Langwieler, Katharina D. Steffani, Dean P. Bogoevski, Oliver Mann, Jakob R. Izbicki. Spontaneous pneumomediastinum. Ann Thorac Surg 2004;78:711-713
DISCLOSURE: The following authors have nothing to disclose: A.p. Kansal, Komaldeep Kaur, Amitesh Gupta, Satinder Kaur, Sudesh Kumari, DonGregory Mascarenhas
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