Spontaneous pneumomediastinum in an adolescent

A case of mediastinal emphysema occurring without etiologic factor except a Valsalva's manoeuvre a few hours before admission in a 15-year-old boy is reported. Symptoms were cervical and chest pain,with moderate dysphagia. Di agnosis was confirmed by palpating subcutaneous air in the neck region and mediastinal air on a chest roentgenogram. A CT scan was performed to exclud e a concurrent pneumothorax. The patient recovered with bed rest. Conclusio n. - Spontaneous pneumomediastinum results from nontraumatic, mediastinal a ir leakage, without underlying lung disease. It should be considered in the differential diagnosis of chest pain, especially in healthy adolescents an d young adults; it is certainly underdiagnosed in this population. (C) 1999 Editions scientifiques et medicales Elsevier SAS.