Mediastinal emphysema as a complication of posterior pharyngeal wall injury – a case report

Mediastinal emphysema is a pathological condition in which air is present in the mediastinum. Mediastinal emphysema may occur spontaneously or as a result of disease or trauma, including iatrogenic injury. Air into the mediastinum may pass from the lungs, trachea, bronchi, esophagus, peritoneal cavity, or come from outside the patient's body. It can also pass from the mediastinum into the neck or abdominal cavity. The mediastinum communicates with the submandibular space, the retropharyngeal space, and the vascular sheaths in the neck. Predisposing factors for mediastinal emphysema include the Valsalva test, physical exertion, increased respiratory effort, coughing, asthma, respiratory infections, vomiting, and drug use. A patient with mediastinal emphysema may present with no symptoms or may present with symptoms of respiratory distress. The most common symptoms observed are retrosternal pain radiating to the shoulder or back and increasing with changes in body position, dyspnea, cough, neck pain or discomfort, dysphagia, tachycardia, and subcutaneous emphysema. The diagnosis is made on the basis of clinical features including the underlying cause and radiological findings. A case of a patient with mediastinal emphysema due to trauma to the posterior pharyngeal wall is presented.