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Pneumomediastinum
Last reviewed: 04.07.2025
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[ What causes pneumomediastinum?
The three main causes of pneumomediastinum are alveolar rupture with air leaking into the mediastinum, esophageal rupture, and gastric or intestinal rupture with air leaking from the neck or abdomen into the mediastinum.
Symptoms of pneumomediastinum
The main symptoms of pneumomediastinum are substernal pain in the lower chest, which can be very severe in some cases. Physical examination reveals subcutaneous emphysema, usually over the sternum, along with a crunching or clicking sound that coincides with the heartbeat, best heard over the cardiac area with the patient lying on the left side (Hamman's sign).
Treatment of pneumomediastinum
Treatment of pneumomediastinum is usually not required, although tension pneumomediastinum with compression of mediastinal structures (which is, however, a rare condition) may require needle aspiration followed by leaving the needle in place, as is done for tension pneumothorax.