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 Pneumomediastinum is the presence of extraluminal gas within
the mediastinum. Gas may originate from the lungs, trachea,
central bronchi, esophagus, and peritoneal cavity and track from
the mediastinum to the neck or abdomen
 In the setting of trauma, if pneumomediastinum is visible on chest
x-ray it is termed overt pneumomediastinum whereas if it is only
visible on CT then it is termed occult pneumomediastinum.
 Pneumomediastinum , also known as Mediastinal Emphysema ,
represents extraluminal gas in the mediastinum
Pneumomediastinum Causes

Injury to the neck or chest
surgery on the neck, chest, or abdomen
Asthma or other conditions that cause forceful coughing
Chest infections and lung diseases, such as COPD and
interstitial lung disease
Difficult childbirth
Excessive vomiting
Continuous Diaphragm Sign ;
Visualization of entire surface of diaphragm from

Naclerio”s V sign ; described on the plain film in patients
with a pneumomediastinum occurring often secondary to
an esophageal rupture

Spinnaker – Sail Sign ; also known as the angel wing sign is a sign
of pneumomediastinum seen on neonatal chest radiographs. It refers to
the thymus being outlined by air with each lobe displaced laterally and
appearing like spinnaker sails

Extra-Pleural Sign ; refers to the appearance of a pulmonary
opacity with oblique margins that taper slowly to the chest wall
when the lesion is viewed tangentially to the x-ray beam


 Pneumomediastinum is manifested by lucent streaks or bubbles of gas
that outline mediastinal structures. Elevate the mediastinal pleura, and
often extend into the neck or chest wall