Pneumomediastinum after injection injury to the hand

Pneumomediastinum as a consequence of injection injury to the hand has not been previously reported. We present a 22-year-old male who developed pneum omediastinum when a high pressure hose injected air into his hand. The anat omic continuity between peripheral ulnar neurovascular bundle and the hilar vessels provided the route for air entering the hypothenar eminence to pen etrate the mediastinum, After ruling out life-threatening causes of pneumom ediastinum such as esophageal perforation, his management included observat ion and serial radiographs. By one week there was complete resolution of th e mediastinal air. This report demonstrates that pneumomediastinum may be a ssociated with air injection injury of the hand, and that expectant managem ent is appropriate.