Spontaneous pneumomediastinum presenting as rhinolalia and chest pain

• Published in: Annals of the Royal College of Surgeons of England Vol. 94; no. 8; pp. e243 - e14
• Main Authors: Breakey, R W F, Walker, G, Oldfield, W
• Format: Journal Article
• Language: English
• Published: England BMJ Publishing Group LTD 01.11.2012; Royal College of Surgeons
• Subjects: Acute Disease; Adult; Chest Pain - diagnostic imaging; Chest Pain - etiology; Dyspnea; Emphysema; Humans; Male; Mediastinal Emphysema - complications; Mediastinal Emphysema - diagnostic imaging; Medical libraries; Medical students; Neck; Online Case Report; Pain; Rare Diseases - complications; Rare Diseases - diagnostic imaging; Speech Disorders - diagnostic imaging; Speech Disorders - etiology; Tomography, X-Ray Computed; United Kingdom > UK; France
• ISSN: 0035-8843; 1478-7083
• DOI: 10.1308/003588412X13373405387339

This report discusses a case of spontaneous pneumomediastinum in a 25-year-old medical student. The patient presented with chest pain and a tonal change in voice. Symptoms occurred after an episode of stretching and were exacerbated by coughing. There was no history of underlying respiratory disease and he was a non-smoker. Management was conservative. At the four-week follow-up appointment, bronchoscopy and computed tomography of the thorax demonstrated complete resolution. Spontaneous pneumomediastinum is uncommon, with rhinolalia being a rare presenting feature. It should be considered as a differential diagnosis in patients with chest pain associated with a change in voice. A detailed history may reveal preceding activities associated with raised intrathoracic pressure.