An Obscure Source of Pneumomediastinum

Ziv Talemi1*, Daniel Fischer1, Svetlana Davidov1 & Zvi Perry1,2

1Department of Surgery A Ward, Soroka University Medical Center, Beer Sheva, Israel
2Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva, Israel

Dr. Ziv Talemi, Department of Surgery A Ward, Soroka University Medical Center, Beer Sheva, Israel.

Keywords: Pneumomediastinum; Free Air; NPO


The current article revolves around the problem of free air in a patient that is a-symptomatic. We bring forth an example of a 62-years-old male who came to our ER with a complaint of abdominal distension. Total body computed tomography (CT) showed pneumoperitoneum, pneumomediastinum, and subcutaneous emphysema in the neck, and comparing it to previous scans showed pneumatosis intestinalis (PI), which was determined to be the most likely source of the patient’s peritoneal, mediastinal, and subcutaneous free air. The patient was admitted to the surgical ward and managed conservatively with nil per os (NPO), intravenous fluids, and antibiotics. In the article, we describe the patient’s history and a brief review of how to deal with free air seen only in imaging.

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This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).

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