Spontaneous pneumomediastinum long-term follow-up

Background: Spontaneous pneumomediastinum (SP) is a rare disorder. Methods: The objective of this study is to examine a series of patients treated during 19 years, analyzing risk, clinical, and diagnostic factors as well as treatment and long-term follow-up. Materials and methods: A descriptive, retrospective study was done from 1984 to 2003 on 32 patients admitted to the hospital with SP. Results: The average age was 21.4 +/- 6.1 years, 24 (75%) males. 34.4% had developed some strain before arriving at the hospital. Nine of the cases were asthmatic (28.1%) and another nine were smokers (28.1%). The most frequent complaint was thoracic pain, 25 (78.1%). In the physical examination, subcutaneous cervical emphysema was observed in 25 patients (78.1%). A simple X-ray of the thorax was used in the diagnosis of 32 cases. In two patients, radiological signs of pneumothorax were discovered. An esophagogram was done on two patients but there were no significant findings. All of the cases were treated conservatively. The average hospital stay was 3.2 +/- 1.6 days. No relapses were noted in the follow-ups. Conclusion: SP is an entity that evolves correctly without treatment and has no long-term relapses. Once other occasionally associated entities are ruled out, outpatient management can be employed. (C) 2005 Elsevier Ltd. All rights reserved.