Journal List > J Korean Diabetes > v.16(2) > 1054967

Shin, Kim, Park, Rhee, Ahn, Park, and Park: Diabetic Ketoacidosis with Spontaneous Pneumomediastinum: A Case Report

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.

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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).
jkd-16-148f1.tif
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).
jkd-16-148f2.tif
Fig. 3.
Esophagography. (A) Cervical portion, (B) thoracic portion, (C) abdominal portion. No demonstrable leakage of contrast media into the soft tissue space.
jkd-16-148f3.tif
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