Spontaneous pneumomediastinum revisited

Abstract

Spontaneous pneumomediastinum is defined as free air within the mediastinum, not associated with trauma. Causes include exercise, drugs, asthma, vomiting, difficult labour and Valsalva maneuvers. It’s a rare, usually benign and self-limited condition, more prevalent in young males. The triad of thoracic pain, dyspnoea and subcutaneous emphysema is typical.

We report a case of a 23 year old man presenting to the emergency room complaining of odynophagia, thoracic pain and neck swelling. He had fever and productive purulent cough in the previous week. He had no abnormal findings but subcutaneous emphysema. We found a pneumomediastinum without pneumothorax, treated conservatively with complete resolution.

Although frightening, this condition usually has good prognosis without specific treatment, other than avoidance of the cause.