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Merck Manual

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Richard W. Light

, MD, Vanderbilt University Medical Center

Last full review/revision Jan 2021| Content last modified Jan 2021
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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.

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