title: Case Series: Pneumorrhachis Secondary to Spontaneous Pneumomediastinum.
abstract: BACKGROUND
  Pneumorrhachis (PR) describes the clinical finding of air within the spinal canal and rarely has been associated with spontaneous pneumomediastinum. There is little medical literature addressing the evaluation and management of these patients in the emergency department.
  
  
  METHODS
  We present a series of patients with PR secondary to a spontaneous pneumomediastinum and briefly review the available literature on the topic to discuss reasonable management strategies for patients presenting with this rare finding. In both cases, the patients had excellent outcomes with expectant management despite the worrisome finding of air in the spinal canal. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Emergency physicians must be able to promptly recognize and appropriately assess even uncommon pathology. As with other rare conditions, there are no published guidelines for the ED management of PR, necessitating the use of case presentations to educate providers as to the complications and plan of care of this diagnosis.
authors.affiliation: Department of Emergency Medicine, Johns Hopkins University, Baltimore, Maryland.
authors.forename: Michael R
authors.initials: MR
authors.lastname: Ehmann
authors.affiliation: Department of Emergency Medicine, Johns Hopkins University, Baltimore, Maryland.
authors.forename: Karolina
authors.initials: K
authors.lastname: Paziana
authors.affiliation: Department of Emergency Medicine, Johns Hopkins University, Baltimore, Maryland.
authors.forename: Andrew I
authors.initials: AI
authors.lastname: Stolbach
mesh_terms: D000328:Adult; D003371:Cough / Q000150:complications; D006801:Humans; D008297:Male; D008478:Mediastinal Emphysema / Q000000981:diagnostic imaging / Q000209:etiology*; D063205:Pneumorrhachis / Q000000981:diagnostic imaging / Q000209:etiology*; D014057:Tomography, X-Ray Computed; D055815:Young Adult
keywords: air; pneumomediastinum; pneumorrhachis; spinal canal