BMJ Case Reports 2017; doi:10.1136/bcr-2017-219494

Paediatric traumatic pneumomediastinum: the spinnaker sail sign

  1. António Horta Oliveira
  1. Serviço de Cirurgia 2, Centro Hospitalar Tondela-Viseu EPE, Viseu, Portugal
  1. Correspondence to Dr Maria João Ferreira, mjp_ferreira{at}
  • Accepted 29 March 2017
  • Published 17 April 2017


A 20-month-old female infant was admitted to the emergency room after being run over by a car. She presented with pallor and signs of impaired peripheral perfusion, despite being conscious and alert. Signs of respiratory distress were recognised. There was a bilateral decrease of respiratory murmurs at pulmonary auscultation and her heart sounds were also diminished. Her peripheral oxygen saturation was 94% and her respiratory rate was 54 breaths per minute. A cervical and thoracic crepitus were present. There were no alterations at abdominal examination. Her blood pressure was 142/58 mmHg.

She presented with a Glasgow Coma …

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