BMJ Case Reports 2018; doi:10.1136/bcr-2017-222965
  • Unusual association of diseases/symptoms

Spontaneous pneumomediastinum

  1. Julian Gaskin
  1. ENT, University Hospitals Bristol NHS Foundation Trust, Bristol, UK
  1. Correspondence to Shilpa Ojha, shilpaojha4{at}
  • Accepted 30 January 2018
  • Published 11 February 2018


Spontaneous pneumomediastinum is the presence of free air within the mediastinum that is not associated with trauma. It is a rare, self-limiting condition that can cause widespread subcutaneous surgical emphysema. We present the case of a 12-year-old boy who presented with widespread spontaneous surgical emphysema and pneumomediastinum, with no history of trauma or respiratory tract disease. We discuss our assessment of him and management with our multidisciplinary team (MDT), and whether radiological investigations including CT are helpful in such cases. In conclusion, we hypothesised that the child’s coughing was the most likely cause of the tracheal rupture leading to the spontaneous surgical emphysema. Spontaneous pneumomediastinum in the paediatric patient is extremely rare. This case highlights how spontaneous pneumomediastinum can be successfully managed conservatively, and how MDT input can be helpful in guiding management in such unusual cases.


  • Contributors SO: writing of report, planning. JG: clinical management, supervisor and data collection.

  • Competing interests None declared.

  • Patient consent Guardian consent obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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