0
July 1967, Vol 114, No. 1 >
Article | July 1967

Pneumomediastinum and Pneumothorax Complicating Asthma in Children FREE

C. Warren Bierman, MD
[+] Author Affiliations

Received for publication Feb 9, 1967.

Reprint requests to Division of Allergy, University of Washington School of Medicine, Seattle 98105 (Dr. Bierman).


Am J Dis Child. 1967;114(1):42-50. doi:10.1001/archpedi.1967.02090220048008.
Text Size: A A A
Published online
Article
References
Comments

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;.
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;.
6 +
McNicholl, B.:  Pneumomediastinum and Subcutaneous Emphysema in Status Asthmaticus, Requiring Surgical Decompression , Arch Dis Child 35:389, 1960;.
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;.
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;.
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;.
11 +
Berkley, H.K., and Coffen, T.H.:  Generalized Interstitial Emphysema and Spontaneous Pneumothorax as Complications of Bronchopneumonia , JAMA 72:535, 1919;.
12 +
Kelman, S.R.:  Experimental Emphysema , Arch Intern Med 24:332, 1919;.
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;.
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;.
19 +
Grossman, J.W., and Cramer, O.S.:  Mediastinal Emphysema Occurring During Acute Paroxysm of Bronchial Asthma , Radiology 52:705, 1949;.
20 +
Derbes, V.J.; Weaver, N.K.; and Cotton, A.L.:  Complications of Bronchial Asthma , Amer J Med Sci 222:88, 1951;.
21 +
Doub, H.P., and Shea, J.J.:  Pneumatosis Cystoides Intestinalis , JAMA 172:1238, 1960;.
22 +
Keyting, W.S., et al:  Pneumatosis Intestinalis: A New Concept , Radiology 76:733, 1961;.
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;.
27 +
Pecora, D.V., et al:  Tracheotomy in the Treatment of Severe Mediastinal Emphysema , JAMA 166:354, 1958;.

Figures

Tables

Interactive Graphics

Video

Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal

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;.
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;.
6 +
McNicholl, B.:  Pneumomediastinum and Subcutaneous Emphysema in Status Asthmaticus, Requiring Surgical Decompression , Arch Dis Child 35:389, 1960;.
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;.
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;.
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;.
11 +
Berkley, H.K., and Coffen, T.H.:  Generalized Interstitial Emphysema and Spontaneous Pneumothorax as Complications of Bronchopneumonia , JAMA 72:535, 1919;.
12 +
Kelman, S.R.:  Experimental Emphysema , Arch Intern Med 24:332, 1919;.
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;.
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;.
19 +
Grossman, J.W., and Cramer, O.S.:  Mediastinal Emphysema Occurring During Acute Paroxysm of Bronchial Asthma , Radiology 52:705, 1949;.
20 +
Derbes, V.J.; Weaver, N.K.; and Cotton, A.L.:  Complications of Bronchial Asthma , Amer J Med Sci 222:88, 1951;.
21 +
Doub, H.P., and Shea, J.J.:  Pneumatosis Cystoides Intestinalis , JAMA 172:1238, 1960;.
22 +
Keyting, W.S., et al:  Pneumatosis Intestinalis: A New Concept , Radiology 76:733, 1961;.
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;.
27 +
Pecora, D.V., et al:  Tracheotomy in the Treatment of Severe Mediastinal Emphysema , JAMA 166:354, 1958;.

Correspondence

Submit a Letter
CME
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Clear Answers | Save For Later
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s “Cited By” API will populate this tab (http://www.crossref.org/citedby.html).
Compression-Only CPR: Pushing the Science Forward
Cone
AAM 2010;304:1493-1495.
All you need to read in the other general journals
BMJ 2010;341:c5893-c1494.
Submit a Comment

Some tools below are only available to our subscribers or users with an online account.

Related Content

Customize your page view by dragging & repositioning the boxes below.

© 2013 American Medical Association. All Rights Reserved.
Powered bySilverchair Information Systems