Chest trauma after a jolly good night out, which had a sour end. Rib fracture?
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Air in the left side of the mediastinum, best illustrated along the lateral aspect of the left heart border.
Surgical emphysema in the right supraclavicular fossa, due to tracking of the mediastinal air.
No pneumothorax. No rib fracture.
Pneumomediastinum can occur for a number of reasons, one of the commonest being chest trauma.
It usually self-resolves, although in other contexts, like esophageal perforation, the cause of its appearances needs addressing first.