Pneumorrhachis with spontaneous pneumomediastinum in pediatric patients: An 11-year retrospective study in Southern Taiwan
Background: Although uncommon, available evidence suggests that pneumorrhachis (PR) with spontaneous pneumomediastinum (SPM) in adulthood is usually benign and self-limiting. This study aimed to review our experience and identify the risk factors of PR in pediatric patients with SPM. Methods: Betwee...
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Elsevier
2023-11-01
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| Series: | Pediatrics and Neonatology |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S1875957223000955 |
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| author | Yu-Tang Chang Chieh-Ni Kao Yu-Ling Huang Hung-Hsing Chiang Jui-Ying Lee Hsien-Pin Li Po-Chih Chang Shah-Hwa Chou Yu-Wei Liu |
| author_facet | Yu-Tang Chang Chieh-Ni Kao Yu-Ling Huang Hung-Hsing Chiang Jui-Ying Lee Hsien-Pin Li Po-Chih Chang Shah-Hwa Chou Yu-Wei Liu |
| author_sort | Yu-Tang Chang |
| collection | DOAJ |
| description | Background: Although uncommon, available evidence suggests that pneumorrhachis (PR) with spontaneous pneumomediastinum (SPM) in adulthood is usually benign and self-limiting. This study aimed to review our experience and identify the risk factors of PR in pediatric patients with SPM. Methods: Between September 2007 and September 2017, SPM in patients aged ≤18 years was retrospectively reviewed and clinical features and outcomes between SPM patients with and without PR were analyzed. Results: In total, thirty consecutive occurrences of SPM in 29 patients were finally identified and classified into SPM (n = 24) and SPM plus PR (n = 6) groups. No significant differences in received interventional exams, prophylactic antibiotic administration or restriction of oral intake between the two groups were found. Both groups were treated with hospitalization predominantly; but the SPM plus PR group tended to have longer length of hospital stay (median 5.5 vs. 3 days, p = 0.08). PR was observed more frequently in patients with abnormal serum C-reactive protein (CRP) levels (>5 mg/L), identified predisposing factors, and those with more severe grade of SPM (p = 0.005, 0.001 and < 0.001, respectively). On multivariable regression analysis, the SPM plus PR group exhibited more predisposing factors than did the SPM group (coefficient: 0.514, standard error: 0.136, p < 0.001). All patients were successfully treated without morbidity and mortality. Conclusion: Although patients with pneumorrhachis retained a higher CRP level, more identified predisposing factors and prolonged inpatient care, conservative management without an extensive work-up would be an appropriate and favorable strategy in pediatrics with concurrent SPM and PR. |
| format | Article |
| id | doaj-art-abc5af1ff82a4c2abb08f54c94234521 |
| institution | Kabale University |
| issn | 1875-9572 |
| language | English |
| publishDate | 2023-11-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Pediatrics and Neonatology |
| spelling | doaj-art-abc5af1ff82a4c2abb08f54c942345212025-08-20T03:24:30ZengElsevierPediatrics and Neonatology1875-95722023-11-0164666767310.1016/j.pedneo.2023.03.008Pneumorrhachis with spontaneous pneumomediastinum in pediatric patients: An 11-year retrospective study in Southern TaiwanYu-Tang Chang0Chieh-Ni Kao1Yu-Ling Huang2Hung-Hsing Chiang3Jui-Ying Lee4Hsien-Pin Li5Po-Chih Chang6Shah-Hwa Chou7Yu-Wei Liu8Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, 80756, Taiwan; School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, 80756, TaiwanDepartment of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, 80756, TaiwanDepartment of Medical Imaging, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, 80756, TaiwanDepartment of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, 80756, TaiwanDepartment of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, 80756, TaiwanDepartment of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, 80756, TaiwanDepartment of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, 80756, Taiwan; School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, 80756, TaiwanDepartment of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, 80756, Taiwan; School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, 80756, TaiwanDepartment of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, 80756, Taiwan; School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, 80756, Taiwan; PhD Program in Environmental and Occupational Medicine, College of Medicine, Kaohsiung Medical University and National Health Research Institutes, Kaohsiung, 80756, Taiwan; Corresponding author. Division of Thoracic Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, No. 100, Tzyou 1st Road, Kaohsiung, 80756, Taiwan.Background: Although uncommon, available evidence suggests that pneumorrhachis (PR) with spontaneous pneumomediastinum (SPM) in adulthood is usually benign and self-limiting. This study aimed to review our experience and identify the risk factors of PR in pediatric patients with SPM. Methods: Between September 2007 and September 2017, SPM in patients aged ≤18 years was retrospectively reviewed and clinical features and outcomes between SPM patients with and without PR were analyzed. Results: In total, thirty consecutive occurrences of SPM in 29 patients were finally identified and classified into SPM (n = 24) and SPM plus PR (n = 6) groups. No significant differences in received interventional exams, prophylactic antibiotic administration or restriction of oral intake between the two groups were found. Both groups were treated with hospitalization predominantly; but the SPM plus PR group tended to have longer length of hospital stay (median 5.5 vs. 3 days, p = 0.08). PR was observed more frequently in patients with abnormal serum C-reactive protein (CRP) levels (>5 mg/L), identified predisposing factors, and those with more severe grade of SPM (p = 0.005, 0.001 and < 0.001, respectively). On multivariable regression analysis, the SPM plus PR group exhibited more predisposing factors than did the SPM group (coefficient: 0.514, standard error: 0.136, p < 0.001). All patients were successfully treated without morbidity and mortality. Conclusion: Although patients with pneumorrhachis retained a higher CRP level, more identified predisposing factors and prolonged inpatient care, conservative management without an extensive work-up would be an appropriate and favorable strategy in pediatrics with concurrent SPM and PR.http://www.sciencedirect.com/science/article/pii/S1875957223000955pediatric patientspneumorrhachisspontaneous pneumomediastinum |
| spellingShingle | Yu-Tang Chang Chieh-Ni Kao Yu-Ling Huang Hung-Hsing Chiang Jui-Ying Lee Hsien-Pin Li Po-Chih Chang Shah-Hwa Chou Yu-Wei Liu Pneumorrhachis with spontaneous pneumomediastinum in pediatric patients: An 11-year retrospective study in Southern Taiwan Pediatrics and Neonatology pediatric patients pneumorrhachis spontaneous pneumomediastinum |
| title | Pneumorrhachis with spontaneous pneumomediastinum in pediatric patients: An 11-year retrospective study in Southern Taiwan |
| title_full | Pneumorrhachis with spontaneous pneumomediastinum in pediatric patients: An 11-year retrospective study in Southern Taiwan |
| title_fullStr | Pneumorrhachis with spontaneous pneumomediastinum in pediatric patients: An 11-year retrospective study in Southern Taiwan |
| title_full_unstemmed | Pneumorrhachis with spontaneous pneumomediastinum in pediatric patients: An 11-year retrospective study in Southern Taiwan |
| title_short | Pneumorrhachis with spontaneous pneumomediastinum in pediatric patients: An 11-year retrospective study in Southern Taiwan |
| title_sort | pneumorrhachis with spontaneous pneumomediastinum in pediatric patients an 11 year retrospective study in southern taiwan |
| topic | pediatric patients pneumorrhachis spontaneous pneumomediastinum |
| url | http://www.sciencedirect.com/science/article/pii/S1875957223000955 |
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