Mediastinal emphysema complicating diabetic ketoacidosis: plea for conservative diagnostic approach

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

*Bijbehorende auteur voor dit werk

Onderzoeksoutputpeer review

28 Citaten (Scopus)


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.

Originele taal-2English
Pagina's (van-tot)368-371
Aantal pagina's4
TijdschriftNetherlands Journal of Medicine
Nummer van het tijdschrift10
StatusPublished - nov-2007

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