PMC:2936739 / 666-2060 JSONTXT

{"project":"2_test","denotations":[{"id":"20859494-15082293-46864392","span":{"begin":201,"end":202},"obj":"15082293"},{"id":"20859494-1824034-46864392","span":{"begin":201,"end":202},"obj":"1824034"},{"id":"20859494-1539891-46864392","span":{"begin":201,"end":202},"obj":"1539891"},{"id":"20859494-10354894-46864393","span":{"begin":360,"end":361},"obj":"10354894"},{"id":"20859494-8615238-46864393","span":{"begin":360,"end":361},"obj":"8615238"},{"id":"20859494-15997870-46864394","span":{"begin":979,"end":980},"obj":"15997870"},{"id":"20859494-17420139-46864394","span":{"begin":979,"end":980},"obj":"17420139"},{"id":"20859494-19934282-46864395","span":{"begin":1076,"end":1078},"obj":"19934282"},{"id":"20859494-19905929-46864395","span":{"begin":1076,"end":1078},"obj":"19905929"},{"id":"20859494-15519176-46864395","span":{"begin":1076,"end":1078},"obj":"15519176"},{"id":"T52633","span":{"begin":201,"end":202},"obj":"15082293"},{"id":"T98893","span":{"begin":201,"end":202},"obj":"1824034"},{"id":"T40489","span":{"begin":201,"end":202},"obj":"1539891"},{"id":"T46752","span":{"begin":360,"end":361},"obj":"10354894"},{"id":"T32163","span":{"begin":360,"end":361},"obj":"8615238"},{"id":"T37618","span":{"begin":979,"end":980},"obj":"15997870"},{"id":"T27064","span":{"begin":979,"end":980},"obj":"17420139"},{"id":"T77617","span":{"begin":1076,"end":1078},"obj":"19934282"},{"id":"T44890","span":{"begin":1076,"end":1078},"obj":"19905929"},{"id":"T9371","span":{"begin":1076,"end":1078},"obj":"15519176"}],"text":"Substernal chest pain during an asthma attack, subcutaneous emphysema in the neck and over the chest and the Hamman’s sign on auscultation should raise the suspicion of a spontaneous pneumomedastinum.[1–4] Air lucency in the soft tissues of the neck, along the cardiac silhouette on CXRPA view and in front of the heart on lateral view confirms the diagnosis.[5–6] This condition usually gets resolved spontaneously and requires only close observation and management of the asthma. 100% oxygen, cervical medastinotomy and tracheotomy are required only in cases of cardiopulmonary distress. Spontaneous pneumomediastinum is defined as the presence of free air in the mediastinal structures without an apparent precipitating cause. Its occurrence ratio is approximately one case per 10,000 hospital admissions,[7] and thus, it may not be very familiar to most of the physicians. Asthma alone accounts for 22-50% spontaneous pneumomedastinum cases, as mentioned in various studies.[8–9] There are several studies published recently about pneumomedastinum in acute severe asthma.[10–13] Asthma is very commonly encountered in clinical practice but medastinal emphysema as its complication is an infrequent problem. Review of literature reveals that less than 100 cases have been published till now. We report a case of spontaneous pneumomedastinum complicating acute severe asthma in an adult male."}