Spontaneous pneumomediastinum in 33 patients: yield of chest computed tomography for the diagnosis of the mild type

Respiration. 2000;67(4):408-11. doi: 10.1159/000029539.


Background: Spontaneous pneumomediastinum (SPM) usually occurs in young people without an apparent precipitating factor or disease. Although there have been many studies focused on the clinical features and standard chest X-ray (CXR) findings of SPM, few have reviewed the chest computed-tomographic (CT) findings.

Objectives: We assessed SPM using CXR and CT, and the relation between them.

Methods: We evaluated 33 patients (26 males) diagnosed with SPM on the basis of symptoms and chest radiological findings.

Results: Three patients showed normal CXR but a diagnostic CT scan. Seven showed mild pneumomediastinum on CXR. In these 10 patients, pneumomediastinum was easily detected by chest CT. Moderate and severe SPM were easily detected by both CXR and CT.

Conclusions: These findings suggested that CXR alone poorly detected approximately 30% of SPM and that chest CT scan was needed to make the diagnosis in these cases. It seems likely that SPM is underdiagnosed by 30% or more in clinical practice.

MeSH terms

  • Adolescent
  • Adult
  • Female
  • Humans
  • Male
  • Mediastinal Emphysema / diagnostic imaging*
  • Mediastinal Emphysema / physiopathology
  • Radiography, Thoracic*
  • Tomography, X-Ray Computed*