title: Pneumomediastinum after inhalation of helium gas from party balloons.
abstract: A previously healthy 16-year-old boy presented to the Emergency Department with a 2-day history of hoarseness, sore throat, and chest tightness. The physical examination was significant for diffuse neck and chest subcutaneous emphysema. A computed tomography (CT) scan of the neck and chest revealed pneumomediastinum after a plain chest X-ray study failed to uncover this finding. The patient reported that 5 days before presentation he forcefully inhaled helium gas directly from multiple party balloons in an attempt to alter his voice. The patient fully recovered over the next 2 days. Spontaneous pneumomediastinum developed in this patient with no underlying lung disease, presumably from air leakage secondary to the excessive elevation of intra-thoracic pressure due to repetitive inhalation of helium gas. Spontaneous pneumomediastinum remains largely underdiagnosed clinically, especially in young, healthy patients.
authors.affiliation: Department of Emergency Medicine, Alameda County Medical Center-Highland General Hospital, Oakland, California 94602, USA.
authors.forename: Brita E
authors.initials: BE
authors.lastname: Zaia
authors.forename: Stephen
authors.initials: S
authors.lastname: Wheeler
mesh_terms: D000280:Administration, Inhalation; D000293:Adolescent; D006371:Helium / Q000009:adverse effects*; D006801:Humans; D007899:Leisure Activities; D008297:Male; D008478:Mediastinal Emphysema / Q000000981:diagnostic imaging / Q000209:etiology*; D010988:Play and Playthings; D014057:Tomography, X-Ray Computed
chemical_list: D006371:Helium