Spontaneous pneumomediastinum

Case contributed by Maciej Mazgaj


Presented to ER with cough and dyspnea after being exposed to dust.

Patient Data

Age: 20 years
Gender: Male

Chest X-ray was completed due to suspicion of spasm bronchitis. Examination revealed lucencies along the left heart border and aortic arch, some lucencies along vasculo-bronchial tree as well as lucencies in right supraclavicular fossa, reflecting sternomastoid muscle fibers. There is also limited subcutaneous emphysema in right supraclavicular fossa.

As the history was not typical for pneumomediastinum a nonenhanced CT was performed to make the diagnosis.

There is free air in the mediastinum, pleural cavities, along the bronchovascular tree, and in the subcutaneous tissue of the neck and right shoulder.

Case Discussion

The patient presented with symptoms suggestive of respiratory system dysfunction, with dyspnea and chest pain. X-ray was suggestive of pneumomediastinum which was asked to be confirmed as the history was not typical for this condition. CT clearly demonstrates the presence of air in the mediastinum, pleural cavities, and subcutaneous tissue.

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