Mediastinal emphysema complicating diabetic ketoacidosis: plea for conservative diagnostic approach

R. G. Pauw*, T. S. Van der Werf, H. M. van Dullemen, Raf Dullaart

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

28 Citations (Scopus)

Abstract

Background: Spontaneous pneumomediastinum has been infrequently reported as a complication of diabetic ketoacidosis. Evidence-based guidelines are currently not available to help in choosing the best diagnostic approach.

Methods: We conducted a systematic review of the literature and looked for diagnostic clues that might indicate the need for a work-up to rule out oesophageal perforation.

Results: In all 56 published cases of spontaneous pneumomediastinum associated with diabetic ketoacidosis, the condition was self-limiting. We report one additional case Of a 31-year-old female who presented with a spontaneous pneumomediastinum and also epidural pneumatosis, complicating diabetic ketoacidosis.

Conclusion: Important pathology, such as oesophageal rupture, was not detected in any of the reported cases, and we suggest a restrictive diagnostic work-up.

Original languageEnglish
Pages (from-to)368-371
Number of pages4
JournalNetherlands Journal of Medicine
Volume65
Issue number10
Publication statusPublished - Nov-2007

Keywords

  • diabetic ketoacidosis
  • epidural pneumatosis
  • pneumomediastinum
  • SPONTANEOUS PNEUMOMEDIASTINUM
  • SUBCUTANEOUS EMPHYSEMA
  • HYPERPNOEA
  • PATIENT
  • PNEUMOTHORAX
  • EXPERIENCE

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