Spontaneous Pneumomediastinum in a Middle-Aged Female Patient With Schizophrenia: A Case Report

TL;DR

A middle-aged woman with schizophrenia and no prior history of anorexia nervosa developed spontaneous pneumomediastinum, a rare condition typically linked to increased intrathoracic pressure.

Contribution

This is the first reported case of spontaneous pneumomediastinum in a schizophrenia patient, highlighting a new clinical association.

Findings

The patient's symptoms of sore throat, neck pain, and dysphagia were attributed to spontaneous pneumomediastinum.

Spontaneous pneumomediastinum in this case was likely due to negative pressure rather than vomiting-related positive pressure.

Chest CT is recommended for diagnosing SPM in schizophrenia patients with unexplained chest or neck pain.

Abstract

A middle-aged female patient with schizophrenia and osteoporosis presented to the emergency department with complaints of sore throat, neck pain, and dysphagia, which was identified as spontaneous pneumomediastinum (SPM) on chest CT. SPM has been reported in anorexia nervosa, but this is the first report of SPM in schizophrenia. In anorexia nervosa, an increase in intrathoracic pressure because of vomiting can cause positive pressure SPM, but this patient was considered to have negative pressure SPM because of decreased mediastinal pressure. In schizophrenia patients with unexplained chest pain, neck pain, and dysphagia, SPM should be considered a differential disease, and a chest CT scan is useful for diagnosis.

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