Background: Post-traumatic pneumomediastinum is air present in the mediastinum compartments following trauma. Mainly the sources of mediastinal air include an injury to the lungs, Pleura, Esophagus, and airways. In addition, it can be through the natural communication from the retropharyngeal neck space to the mediastinum after a blunt neck injury. However, it can also occur from small airway injury secondary to a sudden increase in intrathoracic pressure and spontaneous healing of the injury. The classic presentations are retrosternal severe chest discomfort and subcutaneous emphysema. They may also present with dyspnoea, tachypnea, tachycardia, or fever. Identifying Precise etiology is not worthy and often its self-limiting condition.
Case Presentation: Here in this case report we are describing an 8-year-old child present after a fall-down accident on stony ground from about 3 m high, sustained blunt chest and neck injury of seven hours. Presented with severe retrosternal chest pain and respiratory distress. Upon examination, he was normotensive, tachypnic, tachycardic, afebrile, and had mild desaturation. Bilateral good air entry all over the lung field, no added sound, and extensive subcutaneous emphysema.
Result: Initially with impression of Lung contusion, patient was stabilized with supportive care; bed rest, oxygen therapy, strict pain control. He was investigated with CXR and Chest CT-scan which showed strong evidence of pneumomediastinum and extensive subcutaneous emphysema. However, no there were no evidence of major airodigestive, Lung injury, no pleural air collection. Our patient was managed with supportive care. Subsequently improved and discharged home.
Conclusion: Thus, stable patient diagnosed with posttraumatic pneumomediastinum, identifying the precise pathology is challenging, even in an ideal setting and rarely necessary. Most patients can be treated with only supportive care and empirical antibiotics. However, in extremely rare case substernal tube mediastinotomy may be required in malignant post traumatic pneumomediastinum.
Keywords: Pneumomediastinum, Subcutaneous emphysema, Macklin effect, mediastinotomy, acute mediastinitis.
Citation: Obolu, M. T. et al., (2025). Post Traumatic Pneumomediustenum in Pediatrics a Case Report of an 8-Year-Old Male Patient. J Sur & Surgic Proce.,3(1):1-6.