P. Guzman Rojas, J. Agostinho, R. Hanna and O. Karasik (2018). Spontaneous Pneumomediastinum as a Consequence of Severe Vomiting in Diabetic Ketoacidosis. Cureus, 10(5), e2562. https://doi.org/10.7759/cureus.2562

PubMed 29974017

[Abstract]
Spontaneous pneumomediastinum (SPM) is a rare entity with a reported incidence of approximately 1:7,000 to 1:100,000 of hospital admissions. It has been described as a complication of various conditions related to increased intrathoracic pressure, like recurrent vomiting, post-partum state, vigorous coughing or sneezing, and others. We present a 25-year-old man who came in with intractable vomiting, secondary to diabetic ketoacidosis (DKA), and was found to have pneumomediastinum on chest imaging. The patient was treated conservatively, eventually recovering and being discharged after several days. SPM is rarely seen as a complication of DKA. Diagnosis and management may present a challenge. Usually, the condition is benign and treated conservatively. We report this case to increase awareness among physicians of possible pneumomediastinum in a young male presenting with DKA and dyspnea and to emphasize the benign course of this condition.