CLINICAL IMAGE
Spontaneous pneumomediastinum after bench press training Tomoya Nishino Department of Emergency and Critical Care Medicine, Tokai University School of Medicine, Shimokasuya143, Isehara city, Kanagawa 259-1193, Japan
Correspondence Tomoya Nishino, Department of Emergency and Critical Care Medicine, Tokai University School of Medicine, Shimokasuya143, Isehara city, Kanagawa 259-1193, Japan. Tel: +81463-93-1121; Fax: +81463-93-3701; E-mail: [email protected]
Key Clinical Message
Funding Information No sources of funding were declared for this study.
Keywords
Spontaneous pneumomediastinum is often associated with asthma and mainly affects adolescent males with a tall, thin body habitus. A 17-year-old man complained of chest and pharyngeal pain after bench press training and spontaneous pneumomediastinum was diagnosed. It should be considered in the differential diagnosis of chest pain of uncertain cause.
Bench press training, chest pain, pharyngeal pain, pneumomediastinum
Received: 15 August 2016; Revised: 13 January 2017; Accepted: 19 January 2017 Clinical Case Reports 2017; 5(4): 535–536 doi: 10.1002/ccr3.857
Question: What is an important consideration in chest pain after training? Answer: pneumomediastinum. A 17-year-old man complained of chest and pharyngeal pain after bench press training. Although pneumothorax was not observed, pneumomediastinum was detected using plain chest computed tomography (CT) (Fig. 1). Upper gastrointestinal examination and fiber-optic bronchoscopy were performed. Upper gastrointestinal
examination revealed no leakage of contrast agent, and fiber-optic bronchoscopy revealed absence of hematoma in the tracheal lumen (Fig. 2). Spontaneous pneumomediastinum was diagnosed, and the patient was treated by making him nil by mouth and initiating antibiotics. Pneumomediastinum was resolved on day 3, and he was discharged. Spontaneous pneumomediastinum should be considered in patients with chest pain after exercise.
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(B)
Figure 1. plain chest computed tomography showing pneumomediastinum. ª 2017 The Authors. Clinical Case Reports published by John Wiley & Sons Ltd. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
535
Spontaneous Pneumomediastinum
(A)
T. Nishino
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Figure 2. Upper gastrointestinal examination (A) showing no leakage of contrast agent and fiberoptic bronchoscopy (B) showing absense of hematoma in the tracheal lumen.
Conflict of Interest The authors state that they have no conflict of interest.
drafting the article, revising it critically for important intellectual content, and final approval of the version to be published.
Authorship TN: contributed to conception and design of the article, acquisition of data, analysis and interpretation of data,
536
ª 2017 The Authors. Clinical Case Reports published by John Wiley & Sons Ltd.
Spontaneous pneumomediastinum after bench press training Tomoya Nishino Department of Emergency and Critical Care Medicine, Tokai University School of Medicine, Shimokasuya143, Isehara city, Kanagawa 259-1193, Japan
Correspondence Tomoya Nishino, Department of Emergency and Critical Care Medicine, Tokai University School of Medicine, Shimokasuya143, Isehara city, Kanagawa 259-1193, Japan. Tel: +81463-93-1121; Fax: +81463-93-3701; E-mail: [email protected]
Key Clinical Message
Funding Information No sources of funding were declared for this study.
Keywords
Spontaneous pneumomediastinum is often associated with asthma and mainly affects adolescent males with a tall, thin body habitus. A 17-year-old man complained of chest and pharyngeal pain after bench press training and spontaneous pneumomediastinum was diagnosed. It should be considered in the differential diagnosis of chest pain of uncertain cause.
Bench press training, chest pain, pharyngeal pain, pneumomediastinum
Received: 15 August 2016; Revised: 13 January 2017; Accepted: 19 January 2017 Clinical Case Reports 2017; 5(4): 535–536 doi: 10.1002/ccr3.857
Question: What is an important consideration in chest pain after training? Answer: pneumomediastinum. A 17-year-old man complained of chest and pharyngeal pain after bench press training. Although pneumothorax was not observed, pneumomediastinum was detected using plain chest computed tomography (CT) (Fig. 1). Upper gastrointestinal examination and fiber-optic bronchoscopy were performed. Upper gastrointestinal
examination revealed no leakage of contrast agent, and fiber-optic bronchoscopy revealed absence of hematoma in the tracheal lumen (Fig. 2). Spontaneous pneumomediastinum was diagnosed, and the patient was treated by making him nil by mouth and initiating antibiotics. Pneumomediastinum was resolved on day 3, and he was discharged. Spontaneous pneumomediastinum should be considered in patients with chest pain after exercise.
(A)
(B)
Figure 1. plain chest computed tomography showing pneumomediastinum. ª 2017 The Authors. Clinical Case Reports published by John Wiley & Sons Ltd. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
535
Spontaneous Pneumomediastinum
(A)
T. Nishino
(B)
Figure 2. Upper gastrointestinal examination (A) showing no leakage of contrast agent and fiberoptic bronchoscopy (B) showing absense of hematoma in the tracheal lumen.
Conflict of Interest The authors state that they have no conflict of interest.
drafting the article, revising it critically for important intellectual content, and final approval of the version to be published.
Authorship TN: contributed to conception and design of the article, acquisition of data, analysis and interpretation of data,
536
ª 2017 The Authors. Clinical Case Reports published by John Wiley & Sons Ltd.
