Sonographic Detection of Spontaneous Pneumomediastinum

Spontaneous pneumomediastinum is an uncommon benign disease that mainly affects young, tall, and thin male patients without evidence of trauma or other underlying pulmonary disease. It is a condition caused by an increase of intrathoracic pressure and air leaking from the trachea, bronchi, alveoli, or esophagus into the mediastinum. Although it is often a self-limiting disease, it requires admission to a hospital to exclude potentially severe underlying diseases. 1 In healthy individuals, it has been related to vomiting, pregnancy, singing, physical efforts, cocaine or ecstasy (3,4-methylenedioxy-N-methylamphetamine) use, and scuba diving. Diagnosis of pneumomediastinum is generally performed by means of chest radiography, but in up to 30% of cases that may be not diagnostic, particularly in emergency settings, 2,3 and computed tomography (CT) may be needed to confirm the diagnosis. We report a case of self-resolving spontaneous pneumomediastinum that was missed by chest radiography in which the diagnosis was suggested by neck sonography.