Pneumomediastinum and pneumorrhachis

Case contributed by Matt Adams
Diagnosis almost certain

Presentation

Sudden chest pain after two days of vomiting.

Patient Data

Age: 25 years
Gender: Male

Streaky linear lucency is seen surrounding the cardiac outline and adjacent to the great vessels in the superior mediastinum. Similar streaky lucency is also seen within the soft tissues of the neck. Linear marking in the right apex of the lung.

Extensive pneumomediastinum and surgical emphysema throughout the neck, also associated with trace bilateral pneumothorax and small volume pneumorrhachis. 

Case Discussion

The findings are most likely secondary to vomiting causing barotrauma from increased bronchoalveolar pressure or from Boerhaave syndrome. Pneumorrhachis refers to the presence of gas within the spinal canal.

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