Macklin effect

Last revised by Liz Silverstone on 2 Nov 2023

The Macklin effect refers to pneumomediastinum caused by alveolar rupture and pulmonary interstitial emphysema tracking to the mediastinum along the peribronchovascular interstitium. This is typically seen in blunt chest trauma or asthma.

Pathology

A sudden rise in intra-alveolar pressure can rupture the alveolar wall and gas can dissect through the interstitium. This is commonly due to severe blunt chest trauma or high-speed deceleration and can co-exist with tracheobronchial tear 1.

Radiographic features

CT

Pulmonary interstitial emphysema with gas tracking along the peribronchovascular sheaths towards the hilum and mediastium.

History and etymology

The pathophysiologic process was first proposed by C C Macklin in 1939 2.

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