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By Richard W. Light, MD, Professor of Medicine, Vanderbilt University Medical Center

Pneumomediastinum is air in the cavity in the central part of the chest (mediastinum).

Air can enter the mediastinum when

  • The small air sacs of the lungs (alveoli) become stretched and torn

  • The esophagus rips or tears

  • The intestine tears, causing air to leak into the chest cavity

Most often, people have chest pain below the breastbone. The pain may be severe.

When doctors do a physical examination, they may hear a crunching or crackling noise when they listen to the chest through a stethoscope. A chest x-ray is done to confirm the diagnosis.

Usually, treatment is not necessary. However, the problem that caused pneumomediastinum may require treatment.