Presentation
One-week history of a non-productive cough, seeking consultation for dyspnea and rib pain.
Patient Data
Both the anteroposterior (AP) and lateral studies show signs indicative of pneumomediastinum, including: subcutaneous emphysema at the right supraclavicular level, the continuous diaphragm sign, and the presence of air density between the muscular planes in the anterior cervical region.
The CT scan confirmed the findings observed on the chest X-ray, revealing an extensive pneumomediastinum extending into the anterior supraclavicular cervical region and bilaterally into the retropectoral space. Additionally, a small pneumothorax was identified in the upper lobe of the right lung
Case Discussion
Spontaneous pneumomediastinum is a relatively common condition, particularly in young patients. In most cases, a chest radiograph is sufficient to confirm the diagnosis and computed tomography often does not identify a cause. In CT studies, it is as important to describe the radiological findings as it is to note the absence of potential etiologies that may contribute to the condition, such as esophageal rupture or laceration, tracheal rupture, pulmonary interstitial abnormalities like emphysema, bullae, trauma, as well as associated entities such as asthma, infectious diseases, or connective tissue disorders.
In the described case, the patient was a young individual without significant pathological or traumatic history, and the CT study revealed no other notable findings. The patient exhibited an appropriate evolution with conservative management, leading to the consideration of idiopathic spontaneous pneumomediastinum.
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