Pneumomediastinum

Case contributed by Dr Henry Knipe

Presentation

Forceful vomiting all night. Now chest pain.

Patient Data

Age: 25 years
Gender: Male
X-ray

Extensive subcutaneous emphysema and pneumomediastinum. No pleural effusion. 

CT

Extensive pneumomediastinum and subcutaneous emphysema. Bilateral pneumothoraces with air tracking along the pleural fissures. Gas also tracks into the thoracic epidural space.

No mediastinal or pleural fluid collection. No leak of oral contrast from the oesophagus. 

Case Discussion

Pneumomediastinum can have a dramatic appearance on imaging. In this case with the history of forceful vomiting, oesophageal rupture was concerning but the imaging features are against this a cause and this is more likely from pulmonary in origin (Macklin effect). 

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Case information

rID: 53639
Case created: 28th May 2017
Last edited: 4th Nov 2017
System: Chest
Inclusion in quiz mode: Included

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