Pneumomediastinum can occur in healthy adults in the absence of trauma if a triggering event occurs.


Patient selection: healthy adult without trauma


Mechanism: increased intra-alveolar pressure


Pneumomediastinum can be clinically overlooked if:

(1) it is mild

(2) soft tissue and subcutaneous emphysema are absent

(3) imaging studies (CT or MRI scan) are not performed


Risk factors:

(1) Valsalva maneuver

(2) asthma

(3) cough

(4) emesis (postoperative, pregnancy, other)

(5) barotrauma


Differential diagnosis:

(1) pneumomediastinum following penetrating trauma

(2) soft tissue emphysema and pneumomediastinum following dental surgery


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