Spontaneous pneumomediastinum: benefits of contrast computed tomography imaging

We report a case of spontaneous pneumomediastinum presenting with chest and anterior neck pain. The clinical findings, differential diagnosis and selection of radiological investigations are discussed. Spontaneous pneumomediastinum is an uncommon condition usually presenting in young patients. Presentation to the otolaryngology department occurs due to the presence of symptoms such as neck pain. Differential diagnoses must be considered and excluded, using the clinical features and the results of radiological investigation. Once the diagnosis is confirmed, conservative management is undertaken. Spontaneous pneumomediastinum is uncommon and the clinical features are variable. The recommended investigation is a computed tomography scan with orally administered, water soluble contrast to exclude important differential diagnoses and thus enable definitive diagnosis.