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
Imaging findings OR Procedure details
Pneumomediastinum presents with a variety of radiographic features. It is mostly seen as translucent gas outlining mediastinal contours, including:
- subcutaneous emphysema
- pneumopericardium - gas anterior to pericardium
- double bronchial wall sign - gas outlining bronchial wall
- continuous diaphragm sign - gas trapped posterior to pericardium
- ring around artery sign - gas around pulomary arteries
- tubular artery sign - gas outlining major aortic branches
- extrapleural sign - gas between parietal pleura and diaphragm
- Naclerios V sign - left lower lateral mediastinal border, usually due to oesophageal rupture
- gas in pulmonary ligament
In paediatric imaging, you may also see:
- thymic wing sign - elevated thymus
- Haystack sign - gas crossing the superior mediastinum9,10
Here we demonstrate several of these signs of varying aetiology.
All of the patients had plain films and then most underwent further imaging, in the form of CT, Barium Swallow or both. Further imaging was performed to delineate the underlying pathology, and determine further management.