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Year : 2012  |  Volume : 29  |  Issue : 3  |  Page : 295-296  

Spontaneous pneumomediastinum with a classical radiological sign

Department of Respiratory Medicine, J. L. N. Medical College, Ajmer, Rajasthan, India

Date of Web Publication28-Jul-2012

Correspondence Address:
Ramakant Dixit
A-60, Chandravardai Nagar, Ajmer - 305 001, Rajasthan
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/0970-2113.99126

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How to cite this article:
Dixit R, George J. Spontaneous pneumomediastinum with a classical radiological sign. Lung India 2012;29:295-6

How to cite this URL:
Dixit R, George J. Spontaneous pneumomediastinum with a classical radiological sign. Lung India [serial online] 2012 [cited 2020 Aug 9];29:295-6. Available from: http://www.lungindia.com/text.asp?2012/29/3/295/99126

A 38-year-old male, with past history of pulmonary tuberculosis, was referred to us with worsening of dyspnea for 4 days. Dyspnea was initially relieved by bronchodilators, but for the past 2 days, there was no effect of the medications given. He denied any history of trauma, drug abuse, or vigorous exercise. His past history was significant for regular, adequate antituberculosis treatment taken 10 years back. Clinical examination revealed a hyperresonant percussion note, reduced intensity of breath sounds on left side, and presence of palpable crepitations over the neck and chest wall suggestive of surgical emphysema. The patient was in respiratory distress with tachypnea (34/min) and hypoxia (89%) on room air. An X-ray of the chest was done urgently [Figure 1].
Figure 1: Can you appreciate a radiological sign?

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Q 1: What are the radiological abnormalities?

Q 2: What is your diagnosis?

Q 3: Briefly discuss the condition with radiological signs.

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   References Top

1.Pierson DJ. Pneumomediastinum. In: Murray JF, Nadel JA, editor. Textbook of respiratory medicine. 2 nd ed, Vol. 2. Philadelphia: WB Saunders Company; 1994. p. 2250-65.  Back to cited text no. 1
2.Joshi N, Dixit R, Purohit SD, Gupta RC, Gupta N, Verma PC. Tracheostomy in life threatening primary spontaneous pneumomediastinum in a 13 year male child- a case report. Lung India 1999;17:75-8.  Back to cited text no. 2
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3.Dixit R, Joshi N. Spontaneous pneumomediastinum and pneumothorax following vomiting. Antiseptic 2002;99:16-7.  Back to cited text no. 3
4.Dixit R, Dave L. Pneumomediastinum with subcutaneous emphysema in silico-tuberculosis patient. Lung India 2007;24:102-4.  Back to cited text no. 4
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5.Dixit R, Joshi N, Prasad N. Pneumomediastinum, pneumothorax and subcutaneous emphysema during radiotherapy in primary cavitating bronchogenic carcinoma. Indian J Chest Dis Allied Sci 2002;44:61-4.  Back to cited text no. 5
6.Beyers ZA, Melanas CF. Radiological signs of pneumomediastinum. Br J Radiol 1987;60:877-9.  Back to cited text no. 6
7.Bejvan SM, Godwin JD, Pneumomediastinum: Old signs and new signs. Am J Radiol 1996;166:1041-8.  Back to cited text no. 7
8.Levin B. The continuous diaphragm sign: A newly recognized sign of pneumomediastinum. Clin Radiol 1973;24:337-8.  Back to cited text no. 8
9.Macpherson P, Davidson JS. Continous diaphragm sign of pneumo-mediastinum. Br Med J 1974;2(5910)119-20.  Back to cited text no. 9
10.Rydell JR. Emergency cervical mediastinotomy for massive mediastinal emphysema. Arch Surg 1955;70:647-53.  Back to cited text no. 10


  [Figure 1], [Figure 2]


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