Pneumomediastinum After Difficult Vaginal Delivery

Abstract

17-year-old primigravida patient presented with chest pain, dyspnea, sore throat and a sensation of swelling in the neck and throat approximately 3 hours after difficult vaginal delivery at home. Breath sounds were equal bilaterally. Physical examination revealed subcutaneous emphysema that expanded from the anterior thorax to the neck. Posteroanterior (PA) chest X-ray showed air in the neck and thoracic computed tomography showed pneumomediastinum. The patient was admitted to our clinic and was started on ampicillin-sulbactam 3 x 1 grams iv, paracetamol 2 x 1000 mg and 3 L/min of oxygen therapy. C-reactive protein (CRP) concentration and erythrocyte sedimentation rate (ESR), which were monitored on a daily basis, showed decline. Repeated chest X-rays did not show any progression. The patient was clinically stable and was discharged from the hospital on the third day. Currently in her third month of follow-up, the patient is stable.