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Case contributed by Assoc Prof Frank Gaillard


Presentation to the emergency departement with sudden onset of left sided pleuritic chest pain.

Patient Data

Age: 20 years
Gender: Male

Small to moderate volume pneumomediastinum tracking up to the base of the neck. Excellent example of the continuous diaphragm sign. No pneumothorax. 


Moderate pneumomediastinum is seen extending superiorly into the neck and tracking laterally into the oblique fissures. 

The pulmonary arteries opacify normally without filling defects to a subsegmental level, no pulmonary emboli detected.  The lungs are within normal limits.

The upper abdominal viscera are unremarkable within the limitations of this study. Esophagus appears normal and no pleural fluid identified. 

Case Discussion

Typical appearances of a pneumomediastinum and pulmonary interstitial emphysema in a young adult. The chest x-ray shows a good example of the continuous diaphragm sign. Asthma is the most likely cause. 

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Case information

rID: 21694
Published: 12th Feb 2013
Last edited: 5th May 2020
System: Chest
Inclusion in quiz mode: Included

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