<?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>1665-1146</journal-id>
<journal-title><![CDATA[Boletín médico del Hospital Infantil de México]]></journal-title>
<abbrev-journal-title><![CDATA[Bol. Med. Hosp. Infant. Mex.]]></abbrev-journal-title>
<issn>1665-1146</issn>
<publisher>
<publisher-name><![CDATA[Instituto Nacional de Salud, Hospital Infantil de México Federico Gómez]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S1665-11462021000500485</article-id>
<article-id pub-id-type="doi">10.24875/bmhim.20000332</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Neumomediastino espontáneo asociado a episodio grave y persistente de hipo]]></article-title>
<article-title xml:lang="en"><![CDATA[Spontaneous pneumomediastinum associated with severe and persistent episode of hiccups]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Patiño-Galeana]]></surname>
<given-names><![CDATA[José L.]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Reveles-García]]></surname>
<given-names><![CDATA[María P.]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Niño-Rodríguez]]></surname>
<given-names><![CDATA[Cindy M.]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Suárez-Ramírez]]></surname>
<given-names><![CDATA[Karen]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Rentería-Solis]]></surname>
<given-names><![CDATA[Iris E.]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Star Medica Infantil Privado Terapia Respiratoria ]]></institution>
<addr-line><![CDATA[Ciudad de México ]]></addr-line>
<country>México</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Star Medica Infantil Privado Unidad de Cuidados Intensivos Neonatales ]]></institution>
<addr-line><![CDATA[Ciudad de México ]]></addr-line>
<country>México</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,Star Medica Infantil Privado Radiología Pediátrica ]]></institution>
<addr-line><![CDATA[Ciudad de México ]]></addr-line>
<country>México</country>
</aff>
<aff id="Af4">
<institution><![CDATA[,Star Medica Infantil Privado Residencia de Pediatría ]]></institution>
<addr-line><![CDATA[Ciudad de México ]]></addr-line>
<country>México</country>
</aff>
<aff id="Af5">
<institution><![CDATA[,Star Medica Infantil Privado Otorrinolaringología Pediátrica ]]></institution>
<addr-line><![CDATA[Ciudad de México ]]></addr-line>
<country>México</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>10</month>
<year>2021</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>10</month>
<year>2021</year>
</pub-date>
<volume>78</volume>
<numero>5</numero>
<fpage>485</fpage>
<lpage>488</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_arttext&amp;pid=S1665-11462021000500485&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_abstract&amp;pid=S1665-11462021000500485&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_pdf&amp;pid=S1665-11462021000500485&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen  Introducción: El neumomediastino espontáneo es la presencia de aire libre en el mediastino que no ocurre por un trauma torácico o esofágico directo. Es un padecimiento muy raro, que usualmente ocurre en pacientes con asma, infecciones respiratorias o aspiración de cuerpo extraño. Se reportan pocos casos asociados a eventos de singultos por reflujo grave.  Caso clínico: Se presenta el caso de una paciente de 10 años con neumomediastino espontáneo y extensión al cuello secundario a un episodio grave y persistente de hipo sin antecedentes de asma, trauma, cirugía, infección aguda, aspiración de cuerpo extraño ni ejercicio intenso con Vasalva.  Conclusiones: La irritación del tercio distal del esófago produjo los episodios graves y persistentes de hipo que incrementaron la presión intratorácica, que a su vez por efecto Macklin, desencadenó el neumomediastino. El diagnóstico se realiza con estudios de imagen. El tratamiento es conservador, con resolución del cuadro clínico entre 5 y 7 días después de la hospitalización.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract  Background: Spontaneous pneumomediastinum is the presence of free air in the mediastinum that does not occur from direct thoracic or esophageal trauma. It is a very rare condition usually related to patients with asthma, respiratory infections, or foreign body aspiration. Only a few cases are reported to be associated with severe reflux events.  Case report: We present the case of a 10-year-old female with spontaneous pneumomediastinum extending to the neck secondary to severe and persistent hiccups, with no history of asthma, trauma, surgery, acute infection, foreign body aspiration, and intense exercise with Vasalva.  Conclusions: The irritation of the distal third of the esophagus produced severe and persistent episodes of hiccups that increased the intrathoracic pressure, which in turn triggered the pneumomediastinum by Macklin effect. The diagnosis is made with imaging studies. The treatment is conservative with resolution of the clinical picture between five and seven days after hospitalization.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Neumomediastino]]></kwd>
<kwd lng="es"><![CDATA[Enfisema subcutáneo]]></kwd>
<kwd lng="es"><![CDATA[Hipo]]></kwd>
<kwd lng="es"><![CDATA[Tomografía]]></kwd>
<kwd lng="es"><![CDATA[Niños]]></kwd>
<kwd lng="en"><![CDATA[Pneumomediastinum]]></kwd>
<kwd lng="en"><![CDATA[Subcutaneous emphysema]]></kwd>
<kwd lng="en"><![CDATA[Hiccups]]></kwd>
<kwd lng="en"><![CDATA[Tomography]]></kwd>
<kwd lng="en"><![CDATA[Children]]></kwd>
</kwd-group>
</article-meta>
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