Pneumomediastinum in children with cough

Secondary pneumomediastinum is usually caused by rupture of the trachea, main bronchi or œsophagus following trauma, endoscopy or ulcerating carcinomata. Spontaneous pneumomediastinum results from interstitial rupture of one or more alveoli during sharp rises in the intra-thoracic and intra-alveolar pressure most commonly in an asthmatic attack. Five children are now reported where this condition appears to have resulted from prolonged and severe coughing. In the case of four of them this was during an attack of measles. One died; the others made a rapid recovery without needing skin incision, confirming the general opinion that pneumomediastinum is usually a benign condition.