Case contributed by Ian Bickle
Diagnosis certain


Young gentleman involved in low impact trauma. Abnormal feeling right side of the neck.

Patient Data

Age: 20 years
Gender: Male

Thin linear outline along the left side of the pericardium, extending towards the aortic arch.

Surgical emphysema in the right supraclavicular fossa.

Lungs clear. No pneumthorax.

Case Discussion

Pneumomediastinum can occur spontaneously or in the context of trauma.

It may be difficult to identify.  In this case, the presence of surgical emphysema alerts the film reader to the possibility of gas elsewhere as its origin (it tracks from the mediastinum).

This film is the type which features in FRCR 2B rapid reporting examinations.

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