Exertion-Induced Spontaneous Pneumomediastinum in a Healthy Young Male: A Case Report

Spontaneous pneumomediastinum (SPM) is an uncommon, self-limiting condition that usually resolves with supportive management. In this condition, air enters the central chest cavity due to increased intra-alveolar pressure, causing alveolar rupture. It is likely seen in young adults who are usually fit and healthy without any underlying disease or pathology. It is a benign condition that can present as chest pain, breathlessness, difficulty swallowing, neck and chest emphysema, and, rarely, hoarseness of voice or odynophagia. We report the case of a 19-year-old male who presented to the emergency department with deep chest pain and bubbles under the skin. He was a non-smoker but had a history of vaping for two years. On examination, he had surgical emphysema in the neck and chest. In this case, the exertional strain from a new gym exercise is likely to have contributed to the alveolar rupture. Chest radiography and computed tomography (CT) of the thorax showed air in the mediastinum. The patient was managed conservatively, supported with analgesia and rest. The symptoms and surgical emphysema resolved after two days, and he was discharged without any complications.