Hexachloroethane (HC) smoke, also known as white smoke, is an obscurant use
d in numerous military situations. Many adverse health effects are associat
ed with the use of white smoke, some of which are potentially life threaten
ing. Inhalation is the most frequent route of injury. Two deaths among U.S.
Army personnel resulted from HC smoke exposure in 1988. As recently as 199
7, a United Nations soldier in Bosnia died after an HC smoke canister was d
ischarged in his tent. Injuries are predominantly pulmonary and range from
cough and dyspnea to chemical pneumonitis, pulmonary edema, and adult respi
ratory distress syndrome. In the case presented, a soldier developed pneumo
mediastinum after exposure to HC smoke. This is the first case reported in
the literature of pneumomediastinum associated with HC smoke inhalation.