19 Pneumomediastinum
Fig. 19.1A This patient has extensive pneumomediastinum.
(With thanks to Dr Godfrey Chatora for providing this radiograph.)
Background
Pneumomediastinum refers to air in the mediastinal cavity. There are several causes including asthma, trauma and Boerhaave syndrome. It can also occur spontaneously.
Boerhaave syndrome refers to rupture of the oesophagus, most often caused by forceful vomiting, and is a diagnosis which should always be thought about as it carries a high mortality (50%). Prompt diagnosis and treatment is required to increase the patient’s chance of survival.
Pneumomediastinum can coexist with pneumothorax and pneumoperitoneum due to gas tracking into other body compartments.
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