Pneumomediastinum Overview
Learn About Pneumomediastinum
Pneumomediastinum is air in the mediastinum. The mediastinum is the space in the middle of the chest, between the lungs and around the heart.
Mediastinal emphysema
Pneumomediastinum is uncommon. The condition can be caused by injury or disease. Most often, it occurs when air leaks from any part of the lung or airways into the mediastinum.
Increased pressure in the lungs or airways may be caused by:
- Too much coughing
- Repeated bearing down to increase abdominal pressure (such as pushing during childbirth or a bowel movement)
- Sneezing
- Vomiting
It may also happen after:
- An infection in the neck or center of the chest
- Rapid rises in altitude, or scuba diving
- Tearing of the esophagus (the tube that connects the mouth and stomach)
- Tearing of the trachea (windpipe)
- Use of a breathing machine (ventilator)
- Use of inhaled recreational drugs, such as marijuana or crack cocaine
- Surgery
- Trauma to the chest
Pneumomediastinum also can occur with collapsed lung (pneumothorax) or other diseases.
There may be no symptoms. The condition usually causes chest pain behind the breastbone, which may spread to the neck or arms. The pain may be worse when you take a breath or swallow.
Often, no treatment is needed because the body will gradually absorb the air. Breathing high concentrations of oxygen may speed this process.
The provider may put in a chest tube if you also have a collapsed lung. You may also need treatment for the cause of the problem. A hole in the trachea or esophagus needs to be repaired with surgery.
University Of Texas Southwestern Medical Center At Dallas
Jason Busigo is a Radiologist and an Interventional Radiologist in Frisco, Texas. Dr. Busigo and is rated as an Advanced provider by MediFind in the treatment of Pneumomediastinum. His top areas of expertise are Pleurisy, Pleural Effusion, Bronchogenic Cyst, and Subcutaneous Emphysema. Dr. Busigo is currently accepting new patients in some locations.
Texas Radiology Associates Llp
Abhishek Thummalakunta is an Interventional Radiologist and a Radiologist in Plano, Texas. Dr. Thummalakunta and is rated as an Experienced provider by MediFind in the treatment of Pneumomediastinum. His top areas of expertise are Ascites, Pleural Effusion, Pleurisy, Bone Marrow Aspiration, and Bone Graft. Dr. Thummalakunta is currently accepting new patients.
Texas Health Physicians Group
Justin Collier is a Thoracic Surgeon and a General Surgeon in Plano, Texas. Dr. Collier and is rated as an Experienced provider by MediFind in the treatment of Pneumomediastinum. His top areas of expertise are Aortic Valve Stenosis, Pneumomediastinum, Pleurisy, Transcatheter Aortic Valve Replacement (TAVR), and Aortic Valve Replacement.
The outlook depends on the disease or events that caused the pneumomediastinum.
Air may build up and enter the space around the lungs (pleural space), causing the lung to collapse.
In rare cases, air may enter the area between the heart and the thin sac that surrounds the heart. This condition is called a pneumopericardium.
In other rare cases, so much air builds up in the middle of the chest that it pushes on the heart and the great blood vessels, so they cannot work properly.
All of these complications require urgent attention because they can be life threatening.
Go to the emergency room or call 911 or the local emergency number if you have severe chest pain or difficulty breathing.
Summary: Barotrauma (pneumothorax, pneumomediastinum) is a well-described complication of Acute Respiratory Distress Syndrome (ARDS), especially in patients with coronavirus disease 2019 (COVID-19) (16.1% in COVID-19, and about 6% in non-COVID-19 ARDS). Macklin effect was recently discovered by our group as an accurate radiological predictor of barotrauma in COVID-19 ARDS; the Investigators also found that...
Published Date: August 19, 2024
Published By: Allen J. Blaivas, DO, Division of Pulmonary, Critical Care, and Sleep Medicine, VA New Jersey Health Care System, Clinical Assistant Professor, Rutgers New Jersey Medical School, East Orange, NJ. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
McCool FD. Diseases of the diaphragm, chest wall, pleura, and mediastinum. In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 86.
Vemana AP, Haider SK. Pneumomediastinum. In: Kliegman RM, St. Geme JW, Blum NJ, et al, eds. Nelson Textbook of Pediatrics. 22nd ed. Philadelphia, PA: Elsevier; 2025:chap 462.