Pneumomediastinum in interstitial lung disease-A case report

Pneumomediastinum (PM) is a relatively rare disease and is defined as changes in pressure gradients within the thoracic cavity secondary to increases in intrathoracic pressure which ultimately leads to rupture of alveoli and dissection of air along the fascial planes of the tracheobronchial tree. PM differs from secondary pneumomediastinum in that the latter, by definition, requires a pathologic etiology. Although the presence of secondary pneumomediastinum on radiographic imaging may be the result of significantly serious events such as chest trauma, esophageal rupture, or infection with gas producing organisms, the natural history of PM tends to be benign and self-limiting, resolving over approximately one week. In this report we describe a case of a patient with underlying pulmonary fibrosis presenting with persistent dyspnea found to have pneumomediastinum on computed tomography (CT) that resolved completely over a 3 day period with the use of high concentration oxygen therapy.