Traumatic Pneumomediastinum: Case Report

Traumatic pneumomediastinum (TPM) is a rare entity. TPM may occur as a result of head, neck and thorax injury and rarely after oral injury. A 43- year- old man was brought to our ED approximately three hours after a motor vehicle accident (MVA) with complaints of angina pectoris and dyspnoea. His positive clinical findings were extensive bilateral subcutaneous emphysema and crepitation on his face, neck and trunk bilaterally. Electrocardiogram showed a first degree AV block. Supine chest x- ray, lateral neck x- ray and thorax CT showed subcutaneous and mediastinal air. After hospitalisation, bronchoscopy and endoscopy were performed with normal findings. On the second day, mediastinotomy was performed due to a pressure effect of the mediastinal emphysema. Complete resolution of the pneumothorax and mediastinal emphysema occurred gradually in the following days. He was discharged without any complication on the 6th day. TPM is an important issue if pre- existing trachea or oesophagus injury is present.