Presentation
Acute exacerbation of asthma and mild retrosternal chest pain.
Patient Data
There is a linear lucency over the left heart border and aortic arch. Additional paratracheal linear lucencies are tracking through to the neck. There is an additional lucency lateral to the left chest wall. A continuous diaphragm sign is also present. The lungs are mildly hyperinflated with 10 posterior ribs visible above the diaphragm.
The findings are consistent with pneumomediastinum and pneumopericardium.
Case Discussion
Pneumomediastinum is a known complication of asthma and tends to affect pediatric and adolescent patients.
The patient's asthma responded well to bronchodilators and steroids. Although his pneumomediastinum was extensive and palpable in his neck, he exhibited no signs of upper airway compromise or cardiac tamponade.
He did not require cross-sectional imaging and was discharged home after 6 hours of observation with a referral to a respiratory clinic for follow-up.
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