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Updated: Apr 20, 2026

Point-of-Care Lung Ultrasound in Adults: Image Acquisition
Published on: March 3, 2023
Spontaneous pneumomediastinum and Macklin effect: Overview and appearance on computed tomography
Sadayuki Murayama1, Shinji Gibo1
1Sadayuki Murayama, Department of Radiology, Graduate School of Medical Science, University of the Ryukyus, Okinawa 903-0215, Japan.
Abstract:
Spontaneous pneumomediastinum (SPM) is described as free air or gas located within the mediastinum that is not associated with any noticeable cause such as chest trauma. SPM has been associated with many conditions and triggers, including bronchial asthma, diabetic ketoacidosis, forceful straining during exercise, inhalation of drugs, as well as other activities associated with the Valsalva maneuver. The Macklin effect appears on thoracic computed tomography (CT) as linear collections of air contiguous to the bronchovascular sheaths. With the recent availability of multidetector-row CT, the Macklin effect has been seen in the clinical setting more frequently than expected. The aim of this review article is to describe the CT imaging spectrum of the Macklin effect in patients with SPM, focusing on the common appearance of the Macklin effect, pneumorrhachis, and persistent SPM with pneumatocele.
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