A 22-year-old boy developed neck swelling and slight dyspnea after frequently diving into a pool. Physical examination revealed subcutaneous emphysema, and a subsequent X-ray examination confirmed the presence of air in the mediastinum. Fiberoptic bronchoscopy revealed localized submucosal hemorrhage and coating beneath the lower margin of the cricoid cartilage, suggesting tracheal repture. However, exploratory surgery of the neck could not confirm a rupture, and the case was diagnosed as spontaneous idiopathic mediastinal emphysema with subcutaneous emphysema.
A travheotomy was then performed for the continuing dyspnea, and antibiotic therapy was prescribed with bed rest. The mediastinal and subcutaneous emphysema gradually subsided within 10 days. On the 11th postoperative day, the tracheostoma was closed and the patient was discharged.
A statistival review was also made of 51 cases of spontaneous mediastinal emphysema including the present case, who have cisited the authors' clinic during the past 5 years.
