PNEUMOMEDIASTINUM AND PNEUMOTHORAX FROM BLUNT CERVICAL TRAUMA IN CHILDREN

Minor blunt cervical injuries in children are relatively common occurr ences leading to serious sequelae in only rare circumstances, yet suff icient impact of even a seemingly minor event may lead to a significan t posterior tracheal wall laceration, resulting in pneumomediastinum w ith or without pneumothorax. Three cases demonstrate how the mechanism of injury does not always match either the severity of initial presen tation or the consequent necessary level of emergent management, Pneum omediastinum without pneumothorax often can be treated conservatively; however, the onset of massive pneumomediastinum and pneumothorax may necessitate both tracheotomy and tube thoracostomy as initial treatmen t.