Presentation
Forceful vomiting all night. Now chest pain.
Patient Data
Age: 25 years
Gender: Male
From the case:
Pneumomediastinum
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Extensive subcutaneous emphysema and pneumomediastinum. No pleural effusion.
From the case:
Pneumomediastinum
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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 esophagus.
Case Discussion
Pneumomediastinum can have a dramatic appearance on imaging. In this case with the history of forceful vomiting, esophageal rupture was concerning but the imaging features are against this a cause and this is more likely from pulmonary in origin (Macklin effect).