Case contributed by Dr Derek Smith


Two days pleuritic chest pain, no shortness of breath. Tachycardic, normal oxygen saturations.

Patient Data

Age: 20 years
Gender: Male

Small left apical pneumothorax.

Subcutaneous emphysema (vertical lucent stripes into neck) and "double bronchial wall sign" suggesting pneumomediastinum. Small rim of air at AP window.

Case Discussion

This is a classical appearance of pneumomediastinum.

With the imaging and the stable status of the patient, this was likely from alveolar rupture allowing air to track into the mediastinum which is a recognized cause of pneumomediastinum.

This can be managed conservatively.

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Case information

rID: 39652
Published: 15th Sep 2015
Last edited: 4th Apr 2020
System: Chest
Inclusion in quiz mode: Included