Spontaneous pneumomediastinum

Description

A 17-year-old male patient presented with non-exertional central chest tightness with gradual onset. There was no history of trauma. Physical examination was normal. CT scan of his thorax showed a pneumomediastinum with no other abnormalities. Further questioning revealed that he was doing vigorous sit-up exercises a few days before his presentation (figure 1). A repeat chest x-ray a few days later showed a resolution of his pneumomediastinum. He was completely well on follow-up a few weeks later without any intervention.¹ The patient was reassured about the benign nature of this uncommon condition.

Figure 1.

(A) Chest x-ray with mild signs of pneumomediastinum as shown by arrows. (B, C) Chest CT scan clearly demonstrating air within the superior mediastinum. No abnormalities were identified in the lung fields.