Spontaneous Pneumomediastinum Presenting with Neck Swelling

Abstract

ABSTRACT Spontaneous Pneumomediastinum (SPM) is a very rare condition with an incidence of 1/30.000 and 1/44.500, and mostly seen in young men. The present article reports a case of SPM with neck swelling in the Emergency Department (ED). A 24-year-old male patient with fever and swelling on both sides of his neck presented at the ED. Physical examination revealed swelling on both parotid glands, neck and facial area. The pulmonary examination revealed a swelling starting from the upper side of the chest and extending toward the neck region and palpation revealed crepitation from the upper wall of the chest to both temporal fossae. Linear air radiolucency was seen in the posteroanterior chest x-ray. A Cervico-Thoracic CT scan revealed “showed” diffuse bilateral and symmetrical emphysema. SPM was diagnosed. He was admitted to the Thoracic Surgery Department for treatment and follow up. Emergency physicians should consider SPM in the differential diagnosis of patients presenting with neck swelling. It should not be forgotten that close patient follow-up is required due to the possibility of severe complications.