Book contents
- Frontmatter
- Contents
- Contributors
- Preface
- Case 1 Tracheal diverticulum/paratracheal air cysts
- Case 2 Tracheal bronchus
- Case 3 Relapsing polychondritis
- Case 4 Tracheobronchopathia osteochondroplastica
- Case 5 Tracheobronchomegaly
- Case 6 Bronchial atresia
- Case 7 Dysmotile cilia syndrome (Kartagener's)
- Case 8 Williams-Campbell syndrome
- Case 9 Horseshoe lung
- Case 10 Sarcoidosis
- Case 11 Lymphangioleiomyomatosis (LAM)
- Case 12 Pulmonary Langerhans cell histiocytosis
- Case 13 Transbronchial biopsy lung injury
- Case 14 Congenital cystic adenomatoid malformation
- Case 15 Lymphocytic interstitial pneumonia
- Case 16 Intralobar sequestration
- Case 17 Erdheim-Chester disease
- Case 18 Exogenous lipoid pneumonia
- Case 19 Pulmonary alveolar proteinosis
- Case 20 Alveolar microlithiasis
- Case 21 Metastatic pulmonary calcification
- Case 22 Pulmonary hamartoma
- Case 23 Carney's triad/pulmonary chondromas
- Case 24 Mycobacterium avium-intracellulare complex (MAC) infection
- Case 25 Mycetoma
- Case 26 Rounded atelectasis
- Case 27 Pneumomediastinum
- Case 28 Fibrosing mediastinitis
- Case 29 Extramedullary hematopoiesis
- Case 30 Thymolipoma
- Case 31 Mature teratoma
- Case 32 Mediastinal bronchogenic cyst
- Case 33 Lateral meningoceles
- Case 34 Peripheral nerve sheath tumors
- Case 35 Fibrovascular polyp
- Case 36 Duplication cyst
- Case 37 Pulsion (epiphrenic) diverticulum
- Case 38 Traction diverticulum
- Case 39 Esophageal downhill varices
- Case 40 Esophageal uphill varices
- Case 41 Esophageal mural thickening
- Case 42 Esophageal dilatation
- Case 43 Penetrating atheromatous ulcer
- Case 44 Intramural hematoma
- Case 45 Aortic dissection
- Case 46 Aortic transection
- Case 47 Coarctation and pseudocoarctation of the aorta
- Case 48 Double aortic arch
- Case 49 Right aortic arch
- Case 50 Pulmonary sling
- Case 51 Takayasu's arteritis
- Case 52 Unilateral absence of a pulmonary artery (UAPA)
- Case 53 Partial anomalous pulmonary venous return (PAPVR)
- Case 54 Pulmonary arteriovenous malformations (PAVMs)
- Case 55 Pulmonary artery sarcoma
- Case 56 Intravascular tumor emboli
- Case 57 Pulmonary veno-occlusive disease
- Case 58 Persistent left SVC
- Case 59 SVC syndrome
- Case 60 Prominent superior intercostal vein
- Case 61 Azygos continuation of the IVC
- Case 62 Recesses of the pericardium
- Case 63 Pericardial effusion
- Case 64 Pericardial cysts
- Case 65 Partial or complete absence of the pericardium
- Case 66 Pleural lipoma
- Case 67 Prominent subpleural fat with chronic pleural disease
- Case 68 Benign fibrous tumor of the pleura (+/− pedicles)
- Case 69 Talc pleurodesis
- Case 70 Morgagni hernia
- Case 71 Bochdalek hernia
- Case 72 Prominent cysterna chyli
- Case 73 Diffuse pulmonary lymphangiomatosis
- Case 74 Lymphangitic carcinomatosis
- Case 75 Pulmonary nodule misregistration on PET/CT
- Case 76 Hot clot artifact
- Case 77 Brown fat on PET/CT
- Case 78 Pulmonary Langerhans cell histiocytosis on PET/CT
- Case 79 Talc pleurodesis on PET/CT
- Case 80 Esophagitis on PET/CT
- Case 81 Takayasu's arteritis on PET/CT
- Case 82 Window and level settings
- Case 83 Stair step artifacts
- Case 84 Streak artifacts
- Case 85 Respiratory motion
- Case 86 Lung reconstruction algorithm
- Index
- References
Case 27 - Pneumomediastinum
Published online by Cambridge University Press: 07 October 2011
- Frontmatter
- Contents
- Contributors
- Preface
- Case 1 Tracheal diverticulum/paratracheal air cysts
- Case 2 Tracheal bronchus
- Case 3 Relapsing polychondritis
- Case 4 Tracheobronchopathia osteochondroplastica
- Case 5 Tracheobronchomegaly
- Case 6 Bronchial atresia
- Case 7 Dysmotile cilia syndrome (Kartagener's)
- Case 8 Williams-Campbell syndrome
- Case 9 Horseshoe lung
- Case 10 Sarcoidosis
- Case 11 Lymphangioleiomyomatosis (LAM)
- Case 12 Pulmonary Langerhans cell histiocytosis
- Case 13 Transbronchial biopsy lung injury
- Case 14 Congenital cystic adenomatoid malformation
- Case 15 Lymphocytic interstitial pneumonia
- Case 16 Intralobar sequestration
- Case 17 Erdheim-Chester disease
- Case 18 Exogenous lipoid pneumonia
- Case 19 Pulmonary alveolar proteinosis
- Case 20 Alveolar microlithiasis
- Case 21 Metastatic pulmonary calcification
- Case 22 Pulmonary hamartoma
- Case 23 Carney's triad/pulmonary chondromas
- Case 24 Mycobacterium avium-intracellulare complex (MAC) infection
- Case 25 Mycetoma
- Case 26 Rounded atelectasis
- Case 27 Pneumomediastinum
- Case 28 Fibrosing mediastinitis
- Case 29 Extramedullary hematopoiesis
- Case 30 Thymolipoma
- Case 31 Mature teratoma
- Case 32 Mediastinal bronchogenic cyst
- Case 33 Lateral meningoceles
- Case 34 Peripheral nerve sheath tumors
- Case 35 Fibrovascular polyp
- Case 36 Duplication cyst
- Case 37 Pulsion (epiphrenic) diverticulum
- Case 38 Traction diverticulum
- Case 39 Esophageal downhill varices
- Case 40 Esophageal uphill varices
- Case 41 Esophageal mural thickening
- Case 42 Esophageal dilatation
- Case 43 Penetrating atheromatous ulcer
- Case 44 Intramural hematoma
- Case 45 Aortic dissection
- Case 46 Aortic transection
- Case 47 Coarctation and pseudocoarctation of the aorta
- Case 48 Double aortic arch
- Case 49 Right aortic arch
- Case 50 Pulmonary sling
- Case 51 Takayasu's arteritis
- Case 52 Unilateral absence of a pulmonary artery (UAPA)
- Case 53 Partial anomalous pulmonary venous return (PAPVR)
- Case 54 Pulmonary arteriovenous malformations (PAVMs)
- Case 55 Pulmonary artery sarcoma
- Case 56 Intravascular tumor emboli
- Case 57 Pulmonary veno-occlusive disease
- Case 58 Persistent left SVC
- Case 59 SVC syndrome
- Case 60 Prominent superior intercostal vein
- Case 61 Azygos continuation of the IVC
- Case 62 Recesses of the pericardium
- Case 63 Pericardial effusion
- Case 64 Pericardial cysts
- Case 65 Partial or complete absence of the pericardium
- Case 66 Pleural lipoma
- Case 67 Prominent subpleural fat with chronic pleural disease
- Case 68 Benign fibrous tumor of the pleura (+/− pedicles)
- Case 69 Talc pleurodesis
- Case 70 Morgagni hernia
- Case 71 Bochdalek hernia
- Case 72 Prominent cysterna chyli
- Case 73 Diffuse pulmonary lymphangiomatosis
- Case 74 Lymphangitic carcinomatosis
- Case 75 Pulmonary nodule misregistration on PET/CT
- Case 76 Hot clot artifact
- Case 77 Brown fat on PET/CT
- Case 78 Pulmonary Langerhans cell histiocytosis on PET/CT
- Case 79 Talc pleurodesis on PET/CT
- Case 80 Esophagitis on PET/CT
- Case 81 Takayasu's arteritis on PET/CT
- Case 82 Window and level settings
- Case 83 Stair step artifacts
- Case 84 Streak artifacts
- Case 85 Respiratory motion
- Case 86 Lung reconstruction algorithm
- Index
- References
Summary
Imaging description
Imaging findings of pneumomediastinum consist of gas outlining the mediastinal structures (Figure 27.1). Gas within the mediastinum may dissect superiorly along the fascial planes, which can lead to subcutaneous emphysema in the neck and anterior chest (Figure 27.1). Occasionally the gas can dissect along the peribronchovascular interstitial tissue into the fissural pleura. A pneumothorax can occur from gas rupturing from the fissural pleura or directly from the mediastinal pleura. The gas can also extend between the heart and diaphragm giving the appearance of air along the entire diaphragm. This is known as the continuous diaphragm sign [1]. Gas in the mediastinum can also dissect to or from the abdomen via the retroperitoneal space (Figure 27.1).
Importance
It is important to know the etiology of a pneumomediastinum. Spontaneous pneumomediastinum generally has a benign course. However, potentially life-threatening complications such as tension pneumothorax or tension pneumomediastinum [2] can occur. Other serious causes of pneumomediastinum include perforation of the esophagus, trachea or bronchus, or hollow abdominal viscus. If pneumomediastinum persists or the etiology is unclear, further evaluation with CT abdomen, esophagram, esophagoscopy, or bronchoscopy may need to be performed.
- Type
- Chapter
- Information
- Pearls and Pitfalls in Thoracic ImagingVariants and Other Difficult Diagnoses, pp. 70 - 71Publisher: Cambridge University PressPrint publication year: 2011