Imaging Case of the Week 489 Answer

The chest x-ray shows presence of pneumomediastinum.

There is a continuous diaphragm sign along with dirty air shadow tracking up the superior mediastinum into the neck.

The patient had further imaging in the form of a CT chest with oral contrast which ruled out esophageal perforation as the cause. Patient was admitted and discharged 48 hours later in a stable condition. A cause was not found for their pneumomediastinum.

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