Spontaneous pneumomediastinum and tracheal injury: An extraordinary case report in an adult

Abstract

Spontaneous pneumomediastinum (SPM) associated with subcutaneous emphysema and tracheal injury following persistent vomiting is rare. Here, we report a case of a young adult who presented to the emergency and trauma department with severe vomiting and abdominal pain, persisting for four days, and denied any symptoms of respiratory distress. Physical examination revealed mild dehydration and abdominal tenderness. A chest X-ray indicated subcutaneous emphysema and pneumomediastinum. A subsequent computed tomography (CT) scan confirmed a tracheal tear, pneumomediastinum, and emphysema. The patient received conservative management, including fluids, adequate analgesia, and antibiotics. Spontaneous cases are often linked to forceful coughing. Diagnosis primarily relies on imaging, mainly CT scans, while bronchoscopy aids in assessing tracheal tears. Treatment typically involves conservative measures like observation, pain management, and antibiotics. The patient was managed conservatively with antibiotics and supportive care in this case. SPM with stable conditions typically respond favorably to conservative treatment, and complete resolution can be anticipated within two days to one week.