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Pneumomediastinum
John P. Lichtenberger, III, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            TERMINOLOGY

            • Synonyms

              • Mediastinal "emphysema"
            • Definitions

              • Air within mediastinum
                • Spontaneous: Usually secondary to Macklin effect
                  • Alveolar rupture leads to air dissection along axial interstitium and into mediastinum
                • Traumatic: Tracheobronchial/esophageal tear

            IMAGING

            • General Features

              • Radiographic Findings

                • CT Findings

                  • Imaging Recommendations

                    DIFFERENTIAL DIAGNOSIS

                      PATHOLOGY

                      • General Features

                        CLINICAL ISSUES

                        • Presentation

                          • Demographics

                            • Natural History & Prognosis

                              • Treatment

                                DIAGNOSTIC CHECKLIST

                                • Consider

                                  • Image Interpretation Pearls

                                    Selected References

                                    1. Bagga B et al: Traumatic airway injuries: role of imaging. Curr Probl Diagn Radiol. 49(1):48-53, 2020
                                    2. De Giacomi F et al: Spontaneous pneumomediastinum in connective tissue diseases. J Clin Rheumatol. 25(6):239-45, 2019
                                    3. Lee SY et al: Hamman syndrome: spontaneous postpartum pneumomediastinum. Intern Med J. 49(1):130-1, 2019
                                    4. Russell DW et al: Searching for the source of the leak: PIE and the Macklin effect. Ann Am Thorac Soc. 15(11):1354-6, 2018
                                    5. Sakai M et al: Frequent cause of the Macklin effect in spontaneous pneumomediastinum: demonstration by multidetector-row computed tomography. J Comput Assist Tomogr. 30(1):92-4, 2006
                                    6. Newcomb AE et al: Spontaneous pneumomediastinum: a benign curiosity or a significant problem? Chest. 128(5):3298-302, 2005
                                    7. Chapdelaine J et al: Spontaneous pneumomediastinum: are we overinvestigating? J Pediatr Surg. 39(5):681-4, 2004
                                    8. Howton JC: Boerhaave's syndrome in a healthy adolescent male presenting with pneumomediastinum. Ann Emerg Med. 43(6):785, 2004
                                    9. Zylak CM et al: Pneumomediastinum revisited. Radiographics. 20(4):1043-57, 2000
                                    Related Anatomy
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                                    Related Differential Diagnoses
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                                    References
                                    Tables

                                    Tables

                                    KEY FACTS

                                    • Terminology

                                      • Imaging

                                        • Top Differential Diagnoses

                                          • Pathology

                                            • Clinical Issues

                                              TERMINOLOGY

                                              • Synonyms

                                                • Mediastinal "emphysema"
                                              • Definitions

                                                • Air within mediastinum
                                                  • Spontaneous: Usually secondary to Macklin effect
                                                    • Alveolar rupture leads to air dissection along axial interstitium and into mediastinum
                                                  • Traumatic: Tracheobronchial/esophageal tear

                                              IMAGING

                                              • General Features

                                                • Radiographic Findings

                                                  • CT Findings

                                                    • Imaging Recommendations

                                                      DIFFERENTIAL DIAGNOSIS

                                                        PATHOLOGY

                                                        • General Features

                                                          CLINICAL ISSUES

                                                          • Presentation

                                                            • Demographics

                                                              • Natural History & Prognosis

                                                                • Treatment

                                                                  DIAGNOSTIC CHECKLIST

                                                                  • Consider

                                                                    • Image Interpretation Pearls

                                                                      Selected References

                                                                      1. Bagga B et al: Traumatic airway injuries: role of imaging. Curr Probl Diagn Radiol. 49(1):48-53, 2020
                                                                      2. De Giacomi F et al: Spontaneous pneumomediastinum in connective tissue diseases. J Clin Rheumatol. 25(6):239-45, 2019
                                                                      3. Lee SY et al: Hamman syndrome: spontaneous postpartum pneumomediastinum. Intern Med J. 49(1):130-1, 2019
                                                                      4. Russell DW et al: Searching for the source of the leak: PIE and the Macklin effect. Ann Am Thorac Soc. 15(11):1354-6, 2018
                                                                      5. Sakai M et al: Frequent cause of the Macklin effect in spontaneous pneumomediastinum: demonstration by multidetector-row computed tomography. J Comput Assist Tomogr. 30(1):92-4, 2006
                                                                      6. Newcomb AE et al: Spontaneous pneumomediastinum: a benign curiosity or a significant problem? Chest. 128(5):3298-302, 2005
                                                                      7. Chapdelaine J et al: Spontaneous pneumomediastinum: are we overinvestigating? J Pediatr Surg. 39(5):681-4, 2004
                                                                      8. Howton JC: Boerhaave's syndrome in a healthy adolescent male presenting with pneumomediastinum. Ann Emerg Med. 43(6):785, 2004
                                                                      9. Zylak CM et al: Pneumomediastinum revisited. Radiographics. 20(4):1043-57, 2000