Understanding Pneumomediastinum: When Air Escapes into Potential Spaces

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The Invictus curriculum continues to expand with new lectures, emphasized content, transcripts, and multiple-choice questions, with Matt Delaney now helping with development. We explore pneumomediastinum and pneumopericardium through a simple balloon analogy: two lungs squishing around the heart where air can leak into potential spaces, sometimes tracking into the neck or even dissecting into the pericardium.

• Invictus curriculum growing with new features and comprehensive content for residents
• Continuous board review is valuable throughout a medical career
• Pneumomediastinum occurs when air leaks into the mediastinum from lungs, esophagus, or trachea
• Air can track into subcutaneous tissues or dissect into the pericardium
• Most pneumomediastinum cases need no treatment and resolve spontaneously
• Tension pneumomediastinum or pneumopericardium may require intervention
• Pneumopericardium can cause tamponade requiring drainage
• Chris Riley demonstrates varying examples of pneumomediastinum on chest x-rays

Check out the full radiology x-ray fundamentals series on EM:RAP for more examples.