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Ooh-rah! An unusual cause of spontaneous pneumomediastinum

Manish Singla1, Joshua Potocko, James Sanstead

  • 1Naval Medical Center, San Diego, 34800 Bob Wilson Drive, San Diego, CA 92134, USA.

Military Medicine
|December 4, 2012
PubMed

Insights

Spontaneous pneumomediastinum (SPM) can occur from forceful yelling. This case highlights an unusual cause of SPM in a U.S. Marine Corps Drill Instructor, emphasizing prompt recognition and treatment.

Area of Science:

  • Medical Case Study
  • Thoracic Medicine
  • Emergency Medicine

Background:

  • Spontaneous pneumomediastinum (SPM) is uncommon and typically benign.
  • SPM is usually associated with trauma, infection, or esophageal rupture.
  • Life-threatening complications include tension pneumomediastinum and viscus rupture.

Observation:

  • A U.S. Marine Corps Drill Instructor developed SPM after prolonged yelling.
  • Symptoms included a sensation of a pop behind the nose.
  • Clinical presentation was stable with 100% oxygen saturation on room air.

Findings:

  • Chest X-rays confirmed pneumomediastinum and subcutaneous emphysema.
  • CT scans revealed air tracking along the trachea, great vessels, and esophagus without pneumothorax or esophageal injury.
  • The patient improved with observation and conservative management.

Implications:

  • This case presents yelling as a novel, non-traumatic cause of SPM.
  • Highlights the importance of considering SPM in occupational settings with high vocal demand.
  • Underscores the need for prompt recognition and management of SPM in primary care and operational environments.

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