Chowdhury D. Mediastinal emphysema in the context of perforated gastric ulcer. World J Clin Cases 2024; 12(15): 2479-2481 [PMID: 38817226 DOI: 10.12998/wjcc.v12.i15.2479]
Corresponding Author of This Article
Debkumar Chowdhury, MBChB, MSc, Academic Editor, Academic Fellow, Attending Doctor, Department of Emergency Medicine, Wythenshawe Hospital, Wythenshawe, Manchester M23 9LT, United Kingdom. dc7740@my.bristol.ac.uk
Research Domain of This Article
Medicine, Research & Experimental
Article-Type of This Article
Editorial
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. May 26, 2024; 12(15): 2479-2481 Published online May 26, 2024. doi: 10.12998/wjcc.v12.i15.2479
Mediastinal emphysema in the context of perforated gastric ulcer
Debkumar Chowdhury
Debkumar Chowdhury, Department of Emergency Medicine, Wythenshawe Hospital, Manchester M23 9LT, United Kingdom
Author contributions: Chowdhury D wrote and revised the manuscript.
Conflict-of-interest statement: There is no associated conflict of interest in the production of the article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Debkumar Chowdhury, MBChB, MSc, Academic Editor, Academic Fellow, Attending Doctor, Department of Emergency Medicine, Wythenshawe Hospital, Wythenshawe, Manchester M23 9LT, United Kingdom. dc7740@my.bristol.ac.uk
Received: February 21, 2024 Revised: April 9, 2024 Accepted: April 11, 2024 Published online: May 26, 2024 Processing time: 82 Days and 10.9 Hours
Abstract
In the context of mediastinal emphysema/pneumomediastinum, the main aetiologies are associated with oesophageal perforation, lung pathology or post head and neck surgery related. The main way to differentiate the pathologies would be through Computed Tomographic Imaging of the Thorax and abdomen with oral and intravenous contrast in the context of triple phase imaging. The causes of pneumomediastinum should be differentiated between traumatic and non-traumatic. Oesophageal perforation (Boerhaave syndrome) is associated with Mackler’s triad in upto 50% of patients (severe retrosternal chest pain, pneumomediastinum, mediastinitis). Whereas in cases of lung pathology this can be associated with pneumothorax and pleural effusion.
Core Tip: It is critically important that the cause of pneumomediastinum is investigated in a timely fashion to ensure that the ensuing comorbidity and mortality is reduced. This editorial highlights the need for early dedicated imaging to ascertain the underlying cause.
