[Pneumomediastinum in a child].
BACKGROUND
Pneumomediastinum is a rare, benign condition in which air leaks through the alveolar membrane and collects in the mediastinum. Typical clinical symptoms include chest pain and dyspnoea. In the absence of underlying pathology, conservative treatment is sufficient for remission. Complications are infrequent.


METHODS
We present a case of a 14-year-old boy with pneumomediastinum arising during physical exercise after an earlier episode of coughing. Physical examination showed subcutaneous emphysema in the neck and praecordial systolic crepitations. A chest X-ray revealed air in the mediastinum. Conservative treatment was sufficient for full clinical and radiographic recovery.


CONCLUSIONS
There was no underlying pathology. The diagnosis was therefore a 'spontaneous pneumomediastinum' possibly caused by a Valsalva manoeuvre after physical exercise and chronic coughing.
Rode Kruis Ziekenhuis, afd. Kindergeneeskunde, Beverwijk, The Netherlands. mrfbosscher@gmail.com
M R Frederiek
MR
Bosscher
Karolien H
KH
Olie-García
Wim M C
WM
van Aalderen
D000293:Adolescent; D006801:Humans; D008297:Male; D008478:Mediastinal Emphysema / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D013902:Radiography, Thoracic