Uncommon clinical presentation: Spontaneous pneumomediastinum with tracheal rupture

Authors : Arun Gangadharan, Arun Gangadharan, Sonisha Gupta, Sonisha Gupta, Ankur Porwal, Ankur Porwal, Antriksh Srivastava, Antriksh Srivastava, Jijo Varghese Jose, Jijo Varghese Jose

DOI : 10.18231/j.jchm.2020.006

Volume : 7

Issue : 1

Year : 2020

Page No : 32-35

Spontaneous pneumomediastinum is a rare finding in a young adult without any co-morbidities or underlying lung pathology. A 22 year old male smoker, of average built presented with complaints of acute cough, throat pain and chest pain of 2 days duration. After admission he had an episode of hemoptysis & developed swelling over the neck and upper chest. Radiological assessment showed subcutaneous emphysema with tracheal tear. There was no pnemothorax. Likely cause of tracheal tear in this case could be either aspiration of a chicken bone leading to a direct injury to trachea or vigorous cough leading to raised intratracheal pressure causing rupture. As there was no pre existing lung diseases and the patient was not in respiratory distress, he was managed conservatively. The patient was discharged after complete recovery. It shows that spontaneous pneumomediastinum can present without pneumothorax, caused by tracheal rupture due to vigorous cough from food aspiration.

Keywords: Spontaneous pneumomediastinum, Tracheal rupture, Subcutaneous emphysema, Tracheal tear, Vigorous cough, Food aspiration, Ganja.


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