# Clinical characteristics of 40 patients with spontaneous pneumomediastinum: a retrospective study and literature review

## TL;DR

This study examines 40 patients with spontaneous pneumomediastinum to understand their symptoms and imaging features for better diagnosis and treatment.

## Contribution

The study provides a detailed clinical and imaging analysis of spontaneous pneumomediastinum cases and reviews relevant literature for diagnostic guidance.

## Key findings

- Acute retrosternal pain was the most common symptom in patients with spontaneous pneumomediastinum.
- The Macklin effect was observed in 38 out of 40 patients, indicating gas accumulation around the mediastinum.
- Symptoms resolved within three days, and mediastinal gas was absorbed as shown in follow-up CT scans.

## Abstract

To investigate the clinical characteristics and imaging features of patients with spontaneous pneumomediastinum (SPM) and conduct a literature review to provide reference strategies for the diagnosis and treatment of the affected population.

A retrospective analysis was conducted on patients diagnosed with SPM via chest computed tomography (CT) at our Hospital from January 2022 to December 2023. General information, clinical manifestations, and imaging findings were collected and analyzed. Relevant domestic and international literature was reviewed, and a comparative analysis was performed.

A total of 40 patients were included in this study. Acute retrosternal pain was the most common symptom (45.0%), followed by varying degrees of dyspnea, shortness of breath, and chest tightness (25.0%), persistent coughing (17.5%), and discomfort or pain in the neck and throat (5%). The Macklin effect was observed in 38 patients, characterized by varying degrees of gas accumulation around the mediastinum near the pulmonary hilum. After three days of treatment, the symptoms resolved, and follow-up chest CT scans indicated absorption of mediastinal gas. Patients showed improvement and were discharged.

The clinical manifestations of SPM are complex and diverse, making it prone to clinical misdiagnosis or delayed diagnosis, which may hinder timely treatment. Chest CT is instrumental in the accurate diagnosis of mild mediastinal emphysema. A comprehensive evaluation, incorporating patient complaints and clinical symptoms with chest CT findings, is essential for accurate diagnosis.