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Pneumomediastinum and Pneumothorax Complicating Asthma in Children

Pneumomediastinum and Pneumothorax Complicating Asthma in Children Abstract THOUGH first recognized by Laennec1 in 1819, and first noted as a complication of childhood asthma in 1850,2 only 20 cases of pneumomediastinum or pneumothorax, or both, complicating acute asthma in children were reported in the world medical literature by 1960.3 Subsequent papers by McGovern et al,3 Jorgenson et al,4 Ozonoff,5 and others6,7 suggest that these conditions complicate childhood asthmatic attacks far more often than had hitherto been suspected. Between 1959 and 1966, 16 asthmatic children in the Pacific Northwest have experienced 20 complications of such extra-pulmonary air. This paper examines clinical manifestations, pathophysiology, treatment, and prognosis of these complications in children. Materials and Methods Between January 1959 and April 1966, 12 children with 15 acute attacks of asthma complicated by pneumomediastinum or pneumothorax were treated at the King County Hospital, the Children's Orthopedic Hospital and Medical Center, and the University Hospital in References 1. Laennec, R.T.: A Treatise on the Diseases of the Chest , J. Forbes (trans.), New York: Hofner Publishing Co. under auspices of NY Academy of Medicine, 1962, p 784. 2. Knott, G.A.: On Emphysema of the Neck Caused by Violent Coughing , Lancet 1:16, 1850.Crossref 3. McGovern, J.P., et al: Mediastinal and Subcutaneous Emphysema Complicating Atopic Asthma in Infants and Children , Pediatrics 27:951, 1961. 4. Jorgensen, J.R.; Falliers, C.J.; and Bukantz, S.C.: Pneumothorax and Mediastinal and Subcutaneous Emphysema in Children With Bronchial Asthma , Pediatrics 31:824, 1963. 5. Ozonoff, M.B.: Pneumomediastinum Associated With Asthma and Pneumonia in Children , Amer J Roentgen 95:112, 1965.Crossref 6. McNicholl, B.: Pneumomediastinum and Subcutaneous Emphysema in Status Asthmaticus, Requiring Surgical Decompression , Arch Dis Child 35:389, 1960.Crossref 7. Payne, T.W., and Geppert, L.J.: Mediastinal and Subcutaneous Emphysema Complicating Bronchial Asthma in a Nine-Year-Old Male , J Allergy 32:135, 1961.Crossref 8. Rackemann, F.M., and Edwards, M.C.: Medical Progress; Asthma in Children; Follow-up Study of 688 Patients After Interval of 20 Years , New Eng J Med 246:815, 1952.Crossref 9. Hamman, L.: Spontaneous Mediastinal Emphysema (Henry Sewell Lecture) , Bull Hopkins Hosp 64:1, 1939. 10. Lawson, J.D.: The Scratch Sign: Valuable Aid in the Diagnosis of Pneumothorax , New Eng J Med 264:88, 1961.Crossref 11. Berkley, H.K., and Coffen, T.H.: Generalized Interstitial Emphysema and Spontaneous Pneumothorax as Complications of Bronchopneumonia , JAMA 72:535, 1919.Crossref 12. Kelman, S.R.: Experimental Emphysema , Arch Intern Med 24:332, 1919.Crossref 13. Macklin, C.C.: Pneumothorax With Massive Collapse From Experimental Local Overinflation of Lung Substance , Canad Med Assoc J 36:414, 1937. 14. Macklin, M.T., and Macklin, C.C.: Malignant Interstitial Emphysema of Lungs and Mediastinum as Important Occult Complication in Many Respiratory Diseases and Other Conditions; Interpretation of Clinical Literature in Light of Laboratory Experiment , Medicine 23:281, 1944.Crossref 15. Polak, B., and Adams, H.: Traumatic Air Embolism in Submarine Escape Training , US Nav Med Bull 30:165, 1932. 16. Von Hayek, H.: The Human Lung , V. E. Krahl (trans.), New York: Hafner Publishing Co., Inc., 1960, p 236. 17. Armstrong, D., and Mitchell, R.S.: Spontaneous Pneumothorax During Steroid Therapy of Rapidly Progressive, Far Advanced Pulmonary Tuberculosis , Amer Rev Resp Dis 82:551, 1960 18. Macklin, C.C.: Transport of Air Along Sheaths of Pulmonic Blood Vessels From Alveoli to Mediastinum; Clinical Implications , Arch Intern Med 64: 913, 1939.Crossref 19. Grossman, J.W., and Cramer, O.S.: Mediastinal Emphysema Occurring During Acute Paroxysm of Bronchial Asthma , Radiology 52:705, 1949.Crossref 20. Derbes, V.J.; Weaver, N.K.; and Cotton, A.L.: Complications of Bronchial Asthma , Amer J Med Sci 222:88, 1951.Crossref 21. Doub, H.P., and Shea, J.J.: Pneumatosis Cystoides Intestinalis , JAMA 172:1238, 1960.Crossref 22. Keyting, W.S., et al: Pneumatosis Intestinalis: A New Concept , Radiology 76:733, 1961.Crossref 23. Derbes, V.J.; Engelhardt, H.T.; and Sodeman, W.A.: Unusual Complications of Bronchial Asthma: Air in Extrapulmonary Spaces , Ann Allerg 3:21, 1945. 24. Deamer, W.C.: " Allergies in Childhood ," in S. Z. Levine (ed.): Advances in Pediatrics , Chicago: vol 11, 1960, Yearbook Publishers, Inc., p 162. 25. Mitchell, H.S., and Bacal, H.L.: Pneumothorax and Interstitial Emphysema in Asthma , Canad Med Assoc J 63:467, 1950. 26. Thaler, M.M., et at: Treatment of Mediastinal and Subcutaneous Emphysema Complicating Asthma in Children , J Pediat 65:75, 1964.Crossref 27. Pecora, D.V., et al: Tracheotomy in the Treatment of Severe Mediastinal Emphysema , JAMA 166:354, 1958.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png American Journal of Diseases of Children American Medical Association

Pneumomediastinum and Pneumothorax Complicating Asthma in Children

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References (33)

Publisher
American Medical Association
Copyright
Copyright © 1967 American Medical Association. All Rights Reserved.
ISSN
0002-922X
DOI
10.1001/archpedi.1967.02090220048008
Publisher site
See Article on Publisher Site

Abstract

Abstract THOUGH first recognized by Laennec1 in 1819, and first noted as a complication of childhood asthma in 1850,2 only 20 cases of pneumomediastinum or pneumothorax, or both, complicating acute asthma in children were reported in the world medical literature by 1960.3 Subsequent papers by McGovern et al,3 Jorgenson et al,4 Ozonoff,5 and others6,7 suggest that these conditions complicate childhood asthmatic attacks far more often than had hitherto been suspected. Between 1959 and 1966, 16 asthmatic children in the Pacific Northwest have experienced 20 complications of such extra-pulmonary air. This paper examines clinical manifestations, pathophysiology, treatment, and prognosis of these complications in children. Materials and Methods Between January 1959 and April 1966, 12 children with 15 acute attacks of asthma complicated by pneumomediastinum or pneumothorax were treated at the King County Hospital, the Children's Orthopedic Hospital and Medical Center, and the University Hospital in References 1. Laennec, R.T.: A Treatise on the Diseases of the Chest , J. Forbes (trans.), New York: Hofner Publishing Co. under auspices of NY Academy of Medicine, 1962, p 784. 2. Knott, G.A.: On Emphysema of the Neck Caused by Violent Coughing , Lancet 1:16, 1850.Crossref 3. McGovern, J.P., et al: Mediastinal and Subcutaneous Emphysema Complicating Atopic Asthma in Infants and Children , Pediatrics 27:951, 1961. 4. Jorgensen, J.R.; Falliers, C.J.; and Bukantz, S.C.: Pneumothorax and Mediastinal and Subcutaneous Emphysema in Children With Bronchial Asthma , Pediatrics 31:824, 1963. 5. Ozonoff, M.B.: Pneumomediastinum Associated With Asthma and Pneumonia in Children , Amer J Roentgen 95:112, 1965.Crossref 6. McNicholl, B.: Pneumomediastinum and Subcutaneous Emphysema in Status Asthmaticus, Requiring Surgical Decompression , Arch Dis Child 35:389, 1960.Crossref 7. Payne, T.W., and Geppert, L.J.: Mediastinal and Subcutaneous Emphysema Complicating Bronchial Asthma in a Nine-Year-Old Male , J Allergy 32:135, 1961.Crossref 8. Rackemann, F.M., and Edwards, M.C.: Medical Progress; Asthma in Children; Follow-up Study of 688 Patients After Interval of 20 Years , New Eng J Med 246:815, 1952.Crossref 9. Hamman, L.: Spontaneous Mediastinal Emphysema (Henry Sewell Lecture) , Bull Hopkins Hosp 64:1, 1939. 10. Lawson, J.D.: The Scratch Sign: Valuable Aid in the Diagnosis of Pneumothorax , New Eng J Med 264:88, 1961.Crossref 11. Berkley, H.K., and Coffen, T.H.: Generalized Interstitial Emphysema and Spontaneous Pneumothorax as Complications of Bronchopneumonia , JAMA 72:535, 1919.Crossref 12. Kelman, S.R.: Experimental Emphysema , Arch Intern Med 24:332, 1919.Crossref 13. Macklin, C.C.: Pneumothorax With Massive Collapse From Experimental Local Overinflation of Lung Substance , Canad Med Assoc J 36:414, 1937. 14. Macklin, M.T., and Macklin, C.C.: Malignant Interstitial Emphysema of Lungs and Mediastinum as Important Occult Complication in Many Respiratory Diseases and Other Conditions; Interpretation of Clinical Literature in Light of Laboratory Experiment , Medicine 23:281, 1944.Crossref 15. Polak, B., and Adams, H.: Traumatic Air Embolism in Submarine Escape Training , US Nav Med Bull 30:165, 1932. 16. Von Hayek, H.: The Human Lung , V. E. Krahl (trans.), New York: Hafner Publishing Co., Inc., 1960, p 236. 17. Armstrong, D., and Mitchell, R.S.: Spontaneous Pneumothorax During Steroid Therapy of Rapidly Progressive, Far Advanced Pulmonary Tuberculosis , Amer Rev Resp Dis 82:551, 1960 18. Macklin, C.C.: Transport of Air Along Sheaths of Pulmonic Blood Vessels From Alveoli to Mediastinum; Clinical Implications , Arch Intern Med 64: 913, 1939.Crossref 19. Grossman, J.W., and Cramer, O.S.: Mediastinal Emphysema Occurring During Acute Paroxysm of Bronchial Asthma , Radiology 52:705, 1949.Crossref 20. Derbes, V.J.; Weaver, N.K.; and Cotton, A.L.: Complications of Bronchial Asthma , Amer J Med Sci 222:88, 1951.Crossref 21. Doub, H.P., and Shea, J.J.: Pneumatosis Cystoides Intestinalis , JAMA 172:1238, 1960.Crossref 22. Keyting, W.S., et al: Pneumatosis Intestinalis: A New Concept , Radiology 76:733, 1961.Crossref 23. Derbes, V.J.; Engelhardt, H.T.; and Sodeman, W.A.: Unusual Complications of Bronchial Asthma: Air in Extrapulmonary Spaces , Ann Allerg 3:21, 1945. 24. Deamer, W.C.: " Allergies in Childhood ," in S. Z. Levine (ed.): Advances in Pediatrics , Chicago: vol 11, 1960, Yearbook Publishers, Inc., p 162. 25. Mitchell, H.S., and Bacal, H.L.: Pneumothorax and Interstitial Emphysema in Asthma , Canad Med Assoc J 63:467, 1950. 26. Thaler, M.M., et at: Treatment of Mediastinal and Subcutaneous Emphysema Complicating Asthma in Children , J Pediat 65:75, 1964.Crossref 27. Pecora, D.V., et al: Tracheotomy in the Treatment of Severe Mediastinal Emphysema , JAMA 166:354, 1958.Crossref

Journal

American Journal of Diseases of ChildrenAmerican Medical Association

Published: Jul 1, 1967

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