Spontaneous pneumomediastinum complicating severe asthma exacerbation

Introduction: Pneumomediastinum is an uncommon condition characterized by the accumulation of air in the mediastinum, which may be secondary to trauma, pneumothorax or perforation of the airways, or spontaneous but can be caused by underlying lung disease, in particular severe acute asthma exacerbation.

Methods: We collected 8 cases of patients who were admitted to our division for pneumo-mediastinum complicating severe asthma exacerbation between January 2020 and December 2023. All our patients underwent a diagnostic protocol including monitoring and chest CT.

Results: The average age of our patients was 21, with a predominance of males. All our patients were known to have asthma but were not followed up and were poorly adherents to treatment, dyspnea was observed in all our patients, the chest X-ray showed linear mediastinal lesion, the CT confirmed the presence of the pneumomediastinum and a pneumopericardium in some patients. Treatment consisted of strict rest, oxygen therapy for hypoxemic patients, treatment of asthma exacerbations, optimization of the controller treatment and therapeutic education.

Conclusions: Pneumomediastinum is a common clinical entity in young adults with severe acute asthma exacerbation, generally benign. This complication can be avoided if asthma is optimally managed.