Spontaneous Pneumomediastinum in Anorexia Nervosa: A Case Report and Review of the Literature on Pneumomediastinum and Pneumothorax

摘要

We report a case of a 20-year-old white woman with the history of anorexia nervosa presenting with spontaneouspneumomediastinum (SPM). On admission, her body mass index (BMI) was 9.9 kg/m~2. Physical examinationrevealed subcutaneous crepitation especially in the axillae, the intercostal spaces, between the scapulae and along thespine. A chest X-ray showed extensive tissue emphysema, especially in the upper mediastinum. In a computedtomography (CT) scan, additional air was found in the upper retroperitoneal space adjacent to the stomach and tothe left of the aorta. The patient recovered clinically within three weeks, and a CT scan showed a complete remissionof the pneumomediastinum and subcutaneous emphysema. Based on this, case review of the literature about thefrequency of pneumomediastinum in young patients with low weight is presented concerning epidemiology,etiology, symptoms, diagnosis, treatment, time to recovery and prognosis.