Management Of Spontaneous Pneumomediastinum: Are Hospitalization And Prophylactic Antibiotic Treatment Necessary? Spontan Pnömomediastinumun Yönetimi: Hastaneye Yatış Ve Profilaktik Antibiyotik Tedavisi Gerekli Midir?
Genel Tip Dergisi, cilt.35, sa.1, ss.129-132, 2025 (Scopus, TRDizin)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 35 Sayı: 1
- Basım Tarihi: 2025
- Doi Numarası: 10.54005/geneltip.1554836
- Dergi Adı: Genel Tip Dergisi
- Derginin Tarandığı İndeksler: Scopus, Directory of Open Access Journals, TR DİZİN (ULAKBİM)
- Sayfa Sayıları: ss.129-132
- Anahtar Kelimeler: Antibiotic, complication, hospitalization, spontaneous pneumomediastinum
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Aim: Spontaneous pneumomediastinum (SPM) is defined as the presence of free air in the mediastinum without concomitant disease. It is rare but usually benign and self-limiting. Usually, patients with SPM are hospitalized and sometimes prophylactic antibiotics are administered to prevent mediastinitis. The present study aims to describe the practices regarding the feasibility of outpatient treatment and follow-up of SPM and the necessity of prophylactic antibiotics. Material and Method: Patients with SPM between August 2020 and December 2023 were retrospectively evaluated. Patients who showed free air in the mediastinum on chest radiography or thorax computed tomography were considered to have SPM and were included in the study. All case records were analysed for demographic data, symptoms, precipitating events, diagnostic studies, prophylactic antibiotic use, length of hospitalization and complications. Results: Of 46 patients included in the study, 29 were male (63.1%) and 17 were female (36.9%). In terms of triggering events, 41.3% of patients (19 of 46) did not have a specific trigger (at rest). Suspected triggering events included asthma attacks, physical exercise, cough (with or without upper respiratory tract infection), sneezing, childbirth, shouting and sneezing. The mean duration of hospitalization was 2.4 days. Prophylactic oral antibiotherapy was administered to 18 patients. No patient developed complications such as tension pneumomediastinum, delayed pneumothorax, airway compromise and mediastinitis. Conclusion: SPM is a benign condition seen primarily in young adults with uneventful recovery. Our study supports the feasibility of outpatient treatment and follow-up in stable patients. However, in patients where the underlying disease requires special treatment and the possibility of mediastinitis or organ perforation cannot be excluded, further diagnostic work-up, prophylactic antibiotics and inpatient treatment are required.