Exercise-associated spontaneous pneumomediastinum in young people: diagnostic assessment, recurrence risk, and considerations for return to sport - a narrative review
DOI:
https://doi.org/10.12775/QS.2026.79.76739Keywords
spontaneous pneumomediastinum, physical exertion, Macklin effect, diagnosis, recurrence, return to sportAbstract
Introduction: Exercise-associated spontaneous pneumomediastinum (SPM) requires differentiation from secondary pneumomediastinum; clinical improvement alone does not establish readiness to resume training.
Aim: To assess diagnosis, recurrence, and considerations for return to sport in young people with exercise-associated SPM.
Materials and methods: A narrative review with targeted PubMed searches. Twenty-four publications from 2021–2026 were purposively selected and their full texts verified. Qualitative synthesis distinguished recommendations from documented return.
Results: Uncomplicated cases generally had favorable outcomes with conservative management. Normal examination findings and a normal initial chest radiograph did not exclude SPM. Clinical series differed in recurrence frequency and noted coexisting asthma in some patients with recurrent episodes. Three of the ten included activity-associated case reports clearly documented resumption of activity.
Conclusions: Return decisions require individual assessment of the episode and comorbidities. Resolution of symptoms or imaging abnormalities does not establish tolerance of full training. Available evidence does not define a universal interval for safe return; prospective data on activity and subsequent outcomes are needed.
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Copyright (c) 2026 Jarosław Józef Kucharski, Zuzanna Zofia Cecot, Maciej Mariusz Lesiczka, Julia Weronika Duszejko, Filip Lenartowicz, Oliwia Gałczyńska, Dawid Oskar Mazurek, Katarzyna Kuklińska, Anna Magdalena Maciaszczyk, Alicja Martyna Lewczuk
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