<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>1561-3194</journal-id>
<journal-title><![CDATA[Revista de Ciencias Médicas de Pinar del Río]]></journal-title>
<abbrev-journal-title><![CDATA[Rev Ciencias Médicas]]></abbrev-journal-title>
<issn>1561-3194</issn>
<publisher>
<publisher-name><![CDATA[Editorial Ciencias Médicas]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S1561-31942022000400018</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Neumomediastino secundario a efecto Macklin: a propósito de un caso]]></article-title>
<article-title xml:lang="en"><![CDATA[Pneumomediastinum secondary to Macklin effect: a case report]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Ochoa Suárez]]></surname>
<given-names><![CDATA[Adrián]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Batista Leyva]]></surname>
<given-names><![CDATA[Manuel Antonio]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[García Enríquez]]></surname>
<given-names><![CDATA[Eylin]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Reyes Canel]]></surname>
<given-names><![CDATA[Otto]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Universidad de Ciencias Médicas de Holguín Hospital Clínico Quirúrgico &#8220;Lucía Íñiguez Landín&#8221; ]]></institution>
<addr-line><![CDATA[Holguín ]]></addr-line>
<country>Cuba</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>08</month>
<year>2022</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>08</month>
<year>2022</year>
</pub-date>
<volume>26</volume>
<numero>4</numero>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.sld.cu/scielo.php?script=sci_arttext&amp;pid=S1561-31942022000400018&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.sld.cu/scielo.php?script=sci_abstract&amp;pid=S1561-31942022000400018&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.sld.cu/scielo.php?script=sci_pdf&amp;pid=S1561-31942022000400018&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[RESUMEN  Introducción:  el neumomediastino es la presencia de aire en el espacio mediastinal procedente de bronquios, alvéolos o de una ruptura esofágica, que viaja a través de las vainas vasculares y los planos tisulares hacia el espacio mediastinal; puede ser categorizado como espontáneo, traumático o secundario.  Objetivo:  describir un paciente con neumomediastino secundario al efecto Macklin.  Caso clínico:  se trata de un paciente masculino de 32 años sin antecedentes médicos, que acude a urgencias refiriendo tos seca, dolor de garganta, dolor al ingerir alimentos, malestar general, dolores articulares a predominio de rodillas y espalda baja y fiebre de 39°C acompañada de escalofríos. El día posterior a su ingreso, tras un acceso de tos, presenta de forma súbita aumento de volumen del cuello y porción superior del tórax, acompañado de dolor en dicha zona, dificultad para respirar y hablar. Al examen en este momento se constata aumento de volumen y crepitación en cuello, fosa supraclavicular, y porción anterosuperior y posterosuperior del tórax (enfisema subcutáneo) así como estertores roncos y sibilantes diseminados en ambos campos pulmonares. Se realiza radiografía de tórax de urgencia que muestra signos sugestivos de enfisema subcutáneo y neumomediastino. Se solicita valoración por servicio de cirugía General y otorrino, los cuales sugieren tratamiento conservador.  Conlusiones:  el neumomediastino es una enfermedad poco frecuente y benigna, sus características clínicas son dolor torácico y enfisema subcutáneo luego de un acceso de tos y evoluciona de forma satisfactoria entre dos y 15 días.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[ABSTRACT  Introduction: pneumomediastinum is the presence of air in the mediastinal space coming from bronchi, alveoli or esophageal rupture, which travels through vascular sheaths and tissue planes to the mediastinal space; it can be categorized as spontaneous, traumatic or secondary.  Objective: to describe a patient with pneumomediastinum secondary to the Macklin effect.  Case report: a 32-year-old male patient with no medical history came to the emergency room with a dry cough, sore throat, pain when eating and general malaise, joint pain predominantly in the knees and lower back, and fever of 39°C with chills. The day after his admission, after an attack of coughing, he suddenly presented an increase in volume of the neck and upper chest, accompanied by pain in this area, difficulty in breathing and speaking. On examination at this time, there was an increase in volume and crepitus in the neck, supraclavicular fossa, and anterosuperior and posterosuperior portion of the thorax (subcutaneous emphysema) as well as hoarse and wheezing rales disseminated in both lung fields. An emergency chest X-ray was performed showing signs suggestive of subcutaneous emphysema and pneumomediastinum. An evaluation by the General Surgery and Otorhinolaryngology Departments was requested, which suggested conservative treatment.  Conclusions: pneumomediastinum is a rare and benign disease, its clinical characteristics are chest pain and subcutaneous emphysema after a coughing fit and it evolves satisfactorily between 2 and 15 days.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[ENFISEMA MEDIASTÍNICO]]></kwd>
<kwd lng="es"><![CDATA[NEUMOMEDIASTINO ESPONTÁNE]]></kwd>
<kwd lng="es"><![CDATA[DIAGNÓSTICO DE NEUMOMEDIASTINO]]></kwd>
<kwd lng="en"><![CDATA[MEDIASTINAL EMPHYSEMA]]></kwd>
<kwd lng="en"><![CDATA[SPONTANEOUS PNEUMOMEDIASTINUM]]></kwd>
<kwd lng="en"><![CDATA[PNEUMOMEDIASTINUM DIAGNOSTIC]]></kwd>
</kwd-group>
</article-meta>
</front><back>
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