Spontaneous pneumomediastinum (SP) is uncommon in children and adolescents. It can be associated with anorexia nervosa (AN), particularly in cases having a preceding history of vomiting. We highlight the case of a 15-year-old girl with SP as the presenting symptom of AN. She lost 10 kilograms (kg) over six months but denied vomiting. She complained of neck swelling and dysphagia. Physical examination revealed subcutaneous crepitations over the neck. X-rays confirmed subcutaneous emphysema and also revealed pneumomediastinum. The patient was managed with oxygen therapy as well as slow re-feeding. A subsequent chest X-ray showed complete resolution in 16 days.
LeeHYLeeELPathyPChanYH. Anorexia nervosa in Singapore: An eight-year retrospective study. Singapore Med J2005;46(6):275–81.
2.
HochlehnertALoweBBludauHBBorstMZipfelSHerzogW. Spontaneous pneumomediastinum in anorexia nervosa: A case report and review of the literature on pneumomediastinum and pneumothorax. Eur Eat Disord Rev2010;18(2):107–15.
3.
ChalumeauMLe ClaincheLSayegNSannierNMichelJLMarianowskiR. Spontaneous pneumomediastinum in children. Pediatr Pulmonol2001;31(1):67–75.
4.
van VeelenIHogemanPHvan ElburgANielsen-AbbringFWHeggelmanBGMahieuHF. Pneumomediastinum: A rare complication of anorexia nervosa in children and adolescents. A case study and review of the literature. Eur J Pediatr2008;167(2):171–4.
5.
delCastilloJBoyarCHessFMillerJ. Atraumatic panmural rupture of the esophagus: Boerhaave syndrome. Ann Emerg Med1983;12(6):385–90.
6.
FilossoPLGarabelloDLyberisPRuffiniEOliaroA. Spontaneous pneumomediastinum: A rare complication of anorexia nervosa. J Thorac Cardiovasc Surg2010;139(4):e79–80.
7.
CoxsonHOChanIHMayoJRHlynskyJNakanoYBirminghamCL. Early emphysema in patients with anorexia nervosa. Am J Respir Crit Care Med2004;170(7):748–52.
8.
MassaroDMassaroGDBarasAHoffmanEPClerchLB. Calorie-related rapid onset of alveolar loss, regeneration, and changes in mouse lung gene expression. Am J Physiol Lung Cell Mol Physiol2004;286(5):L896–906.
