Type:
Educational Exhibit
Keywords:
Acute, Contrast agent-oral, Fluoroscopy, Plain radiographic studies, CT, Mediastinum
Authors:
T. Paterson, A. Gupta, C. Jenkinson; WA/AU
DOI:
10.26044/ranzcr2019/R-0041
Background
Pneumomediastinum is defined as the presence of air in the mediastinum. This can be spontaneous or secondary, with iatrogenic, traumatic and non-traumatic causative factors.1,3 There are various radiological signs associated with the pneumomediastinum, and it can present with concurrent abnormalities, such as pneumothorax, pneumoperitoneum and pneumopericardium.3-5 Pneumomediastinum is rare and diagnosis is usually made through plain radiographs.1,4 However, further imaging such as CT scans and contrast swallows can be used for differentiating diagnoses, assessing the extent of the pneumomediastinum and identifying the causative pathology.5-9 Identifying the underlying pathology can have a significant impact on the management of the patients. Depending on the pathophysiology and associated complications, some cases of pneumomediastinum can be relatively benign, whilst others can require significant intervention.2
We retrospectively reviewed all cases of pneumomediastinum identified in tertiary hospitals in Western Australia over a 10-year period. We evaluated the common radiological features on plain radiographs and compared it to other CT scan and contrast swallow imaging signs, noting the pathophysiology and any associated abnormalities.