complained man A 27-year-old left-sided, respiration-related thoracic pain every time he swallowed food or drink. He was known to have history of chronic renal insufficiency with IgA nephropathy and well-controlled bronchial asthma. His vital signs and electrocardiographic findings were normal, but rale was detected on palpation of the neck. Thoracic radiography and subsequent computed tomography show marked pneumomediastinum with pneumopericardium, small, left-sided ventral pneumothorax, and right-sided cervical soft-tissue emphysema. No contrast medium was observed in the mediastinum. Esophagogastroscopy showed intact mucosae. The patient received symptomatic treatment, and radiological follow-up 5 days later revealed clear regression of the pneumomediastinum with residual cervical air pockets. Spontaneous pneumomediastinum is relatively rarely occurring entity (estimated incidence 1: 7000 to 1:45 000) that is seen most frequently in young men and is generally self-limiting. Endoscopy is not absolutely necessary in clinically stable patient.
PD Dr. Radovan Vasko, Prof. Gerhard Anton Müller, Clinic for Nephrology and Rheumatology, Georg-August-Universität Göttingen, firstname.lastname@example.org
Conflict of interest statement: The authors declare that no conflict of interest exists.
Translated from the original German by David Roseveare
Cite this as: Vasko R, Müller GA: A 27-year-old man with abruptly occurring chest pain on swallowing. Dtsch Arztebl Int 2018; 115: 652. DOI: 10.3238 / arztebl.2018.0652