J Korean Diabetes.  2015 Jun;16(2):148-152. 10.4093/jkd.2015.16.2.148.

Diabetic Ketoacidosis with Spontaneous Pneumomediastinum: A Case Report

• Shin SH
• Kim DM
• Park JR
• Rhee SY
• Ahn JS
• Park HM
• Park IY

• KMID: 2137274
• DOI: http://doi.org/10.4093/jkd.2015.16.2.148

Abstract

Spontaneous pneumomediastinum (SPM) is defined as the presence of extraluminal gas in the mediastinal space without any clear traumatic cause. It has been reported in association with asthma exacerbation, emesis, childbirth, seizure, excessive shouting, drug inhalation and diabetic ketoacidosis (DKA). SPM complicated by DKA is infrequently accompanied with chest pain and DKA can lead to changes in respiratory rate and depth; this complication might be underestimated. Here, we report a 21-year-old male with throat pain on swallowing due to SPM complicated by DKA. Clinicians need to consider this complication in differential diagnoses.

Keyword

Diabetic ketoacidosis; Diagnostic; Mediastinal emphysema; Pneumomediastinum

MeSH Terms

Asthma
Chest Pain
Deglutition
Diabetic Ketoacidosis*
Diagnosis, Differential
Humans
Inhalation
Male
Mediastinal Emphysema*
Parturition
Pharynx
Respiratory Rate
Seizures
Vomiting
Young Adult

Figure

• 

  Fig. 1. (A) Postero-anterior view and (B) left-lateral view chest radiograph. (A) The radiolucent lines beside the aorta indicate the mediastinal emphysema (arrows). (B) The presence of air dissecting the posterior cardiac border and mediastinal structures is demonstrated by left-lateral view (arrows).

• 

  Fig. 2. Neck and chest computed tomography. (A, B) Diffuse air density lesions from nasopharynx to mediastinum and (C) soft tissue emphysema were seen (arrows).

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  Fig. 3. Esophagography. (A) Cervical portion, (B) thoracic portion, (C) abdominal portion. No demonstrable leakage of contrast media into the soft tissue space.

Reference

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