{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T23:31:24Z","timestamp":1788305484845,"version":"build-2803163510"},"reference-count":23,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pediatr Emer Care"],"published-print":{"date-parts":[[2017,5]]},"abstract":"<jats:sec>\n            <jats:title>Introduction<\/jats:title>\n            <jats:p>Described since 1939 in the adult population, spontaneous pneumomediastinum is less known in children. Because of its symptoms and a generally benign evolution, it is probably an underestimated diagnosis. However, it has to be considered in the differential diagnosis of acute thoracic pain.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>The incidence being low, we conducted a narrative literature review to identify the circumstances leading to a spontaneous pneumomediastinum, the most relevant signs and symptoms, investigations, as well as treatment recommendations.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>Of 216 patients, 66.2% are boys, and mean ages range from 6.9 to 14 years. The most frequent comorbidity in children is asthma (22.2%), and the most common trigger factors are bronchospasm (49%), cough (45.6%), various respiratory tract infections, vomiting (10.3%), and foreign body aspiration (8.3%). It remains idiopathic in 33.3%. Relevant signs are chest pain (54.6%), neck pain and\/or sore throat (53.3%), and dyspnea (41.2%). The most relevant sign is palpation of subcutaneous emphysema (66.4%). The classically described Hamman crunch is only present in 11.6%. Chest x-ray provides the right diagnosis in 99.5% of the patients. Pneumothorax is associated in 11.6%. Most patients are hospitalized (88.3%); treatment is based on oxygen therapy, painkillers, and rest. In some series, there can be up to 25.8% of patients requiring intensive care and 5.5% requiring drainage of associated pneumothorax. Survival rate is 92.5%, and long-term follow-up shows normal x-rays after 4 days and no recurrence.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p>Spontaneous pneumomediastinum is uncommon in children but must be considered in pediatric patients with acute chest and\/or neck pain. History taking, physical examination, and standard chest x-ray are most often diagnostic, and there is rarely a need for other investigation.<\/jats:p>\n            <jats:p>Hospitalization is not always indispensable; ambulatory management can be considered. Outcome is good, and follow-up can be clinical, therefore avoiding further x-rays.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1097\/pec.0000000000000625","type":"journal-article","created":{"date-parts":[[2016,2,6]],"date-time":"2016-02-06T18:42:11Z","timestamp":1454784131000},"page":"370-374","source":"Crossref","is-referenced-by-count":46,"title":["Pediatric Spontaneous Pneumomediastinum"],"prefix":"10.1097","volume":"33","author":[{"given":"Celine Rey-Bellet","family":"Gasser","sequence":"first","affiliation":[{"name":"From the *Division of Pediatric Emergency Medicine, Department of Paediatrics, Children's Hospital; and \u2020Division of Pediatric Intensive Care, Department of Paediatrics, CHUV, Lausanne; and \u2021Division of Pediatric Emergency Medicine, H\u00f4pital Cantonal, Fribourg, Switzerland."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel","family":"Pellaton","sequence":"additional","affiliation":[{"name":"From the *Division of Pediatric Emergency Medicine, Department of Paediatrics, Children's Hospital; and \u2020Division of Pediatric Intensive Care, Department of Paediatrics, CHUV, Lausanne; and \u2021Division of Pediatric Emergency Medicine, H\u00f4pital Cantonal, Fribourg, Switzerland."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cosette Pharisa","family":"Rochat","sequence":"additional","affiliation":[{"name":"From the *Division of Pediatric Emergency Medicine, Department of Paediatrics, Children's Hospital; and \u2020Division of Pediatric Intensive Care, Department of Paediatrics, CHUV, Lausanne; and \u2021Division of Pediatric Emergency Medicine, H\u00f4pital Cantonal, Fribourg, Switzerland."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"bib1-20231023","first-page":"1","article-title":"Spontaneous mediastinal emphysema","volume":"64","year":"1939","journal-title":"Bull Johns Hopkins Hosp"},{"key":"bib2-20231023","doi-asserted-by":"crossref","first-page":"913","DOI":"10.1001\/archinte.1939.00190050019003","article-title":"Transport of air along sheaths of pulmonic blood vessels from alveoli to mediastinum","volume":"64","year":"1939","journal-title":"Arch Intern Med"},{"key":"bib3-20231023","doi-asserted-by":"crossref","first-page":"138","DOI":"10.3109\/01443615.2013.830597","article-title":"Spontaneous neonatal pneumomediastinum: radiological or clinical diagnosis?","volume":"34","year":"2014","journal-title":"J Obstet Gynaecol"},{"key":"bib4-20231023","doi-asserted-by":"crossref","first-page":"681","DOI":"10.1016\/j.jpedsurg.2004.01.045","article-title":"Spontaneous pneumomediastinum: are we overinvestigating?","volume":"39","year":"2004","journal-title":"J Pediatr Surg"},{"key":"bib5-20231023","doi-asserted-by":"crossref","first-page":"869","DOI":"10.1002\/ppul.21124","article-title":"Etiologies of spontaneous pneumomediastinum in children in middle Taiwan","volume":"45","year":"2010","journal-title":"Pediatr Pulmonol"},{"key":"bib6-20231023","doi-asserted-by":"crossref","first-page":"190","DOI":"10.1016\/S1875-9572(09)60062-0","article-title":"Etiologies of spontaneous pneumomediastinum in children of different ages","volume":"50","year":"2009","journal-title":"Pediatr Neonatol"},{"key":"bib7-20231023","first-page":"1652","article-title":"Spontaneous pneumomediastinum in a 4-month-old boy","volume":"15","year":"2008","journal-title":"Arch Pediatr"},{"key":"bib8-20231023","doi-asserted-by":"crossref","first-page":"3298","DOI":"10.1378\/chest.128.5.3298","article-title":"Spontaneous pneumomediastinum: a benign curiosity or a significant problem?","volume":"128","year":"2005","journal-title":"Chest"},{"key":"bib9-20231023","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1002\/1099-0496(200101)31:1<67::AID-PPUL1009>3.0.CO;2-J","article-title":"Spontaneous pneumomediastinum in children","volume":"31","year":"2001","journal-title":"Pediatr Pulmonol"},{"key":"bib10-20231023","doi-asserted-by":"crossref","first-page":"1110","DOI":"10.1016\/j.ejcts.2007.03.008","article-title":"Spontaneous pneumomediastinum: 41 cases","volume":"31","year":"2007","journal-title":"Eur J Cardiothorac Surg"},{"key":"bib11-20231023","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1378\/chest.100.1.93","article-title":"Spontaneous pneumomediastinum. 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Pneumothorax or pneumomediastinum?","volume":"102","year":"1992","journal-title":"Chest"},{"key":"bib23-20231023","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1016\/j.jpedsurg.2003.09.043","article-title":"Idiopathic spontaneous pneumomediastinum: an uncommon emergency in children","volume":"39","year":"2004","journal-title":"J Pediatr Surg"}],"container-title":["Pediatric Emergency Care"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.lww.com\/00006565-201705000-00017","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,23]],"date-time":"2023-10-23T02:02:47Z","timestamp":1698026567000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/00006565-201705000-00017"}},"subtitle":["Narrative Literature Review"],"short-title":[],"issued":{"date-parts":[[2017,5]]},"references-count":23,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2017]]}},"URL":"https:\/\/doi.org\/10.1097\/pec.0000000000000625","relation":{},"ISSN":["1535-1815","0749-5161"],"issn-type":[{"value":"1535-1815","type":"electronic"},{"value":"0749-5161","type":"print"}],"subject":[],"published":{"date-parts":[[2017,5]]}}}