Spontaneous pneumomediastinum in a pediatric patient after a 1600-m run: Case report and literature review

Abstract

Pneumomediastinum occurs as a result of traumatic or iatrogenic causes or in patients with preexisting lung conditions such as interstitial lung disease, asthma, and chronic obstructive pulmonary disease. Spontaneous pneumomediastinum (SPM), however, is rarely seen in clinical practice. The authors report the case of a 14-year-old boy who presented to the emergency department with chest discomfort and shortness of breath after a 1600-m run as part of a physical education class. The patient was found to have SPM, was admitted to the pediatric service for monitoring and pain control, and made a full recovery within 24 hours. This case is notable because SPM occurred in the absence of identifiable organic causes and as the result of sustained noncontact physical activity. A review of the literature provides background information and highlights pathophysiologic processes of SPM and suggested treatment. Physicians should consider pneumomediastinum in young patients or runners presenting with chest pain even in the absence of any known inciting event.