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. 2016 Jun;9(2):178-81.
doi: 10.21053/ceo.2014.01543. Epub 2016 Apr 19.

Spontaneous Retropharyngeal and Mediastinal Emphysema

Do-Yeon Cho  1 , Geoffrey P Aaron  1 , Kimberly G Shepard  2
Affiliations

Spontaneous Retropharyngeal and Mediastinal Emphysema

Do-Yeon Cho et al. Clin Exp Otorhinolaryngol. 2016 Jun.

Abstract

A 14-year-old girl with no significant medical history presented at Emergency Department with sore throat and odynophagia after one episode of nonviolent coughing. She denied any respiratory distress, voice change, foreign body ingestion, retching, substance abuse, dental procedures, or trauma. She was afebrile with normal oxygen saturation and physical examination including the head and neck was unremarkable with the exception of bilateral neck crepitus without tenderness on palpation. Fiberoptic laryngoscopy revealed a patent laryngeal airway with normal vocal fold movement. Lateral neck X-ray demonstrated a linear air-column in the retropharyngeal space and computed tomography confirmed emphysema involving the retropharyngeal space and mediastinum with no evidence of fluid collection or abscess formation. Spontaneous retropharyngeal and mediastinal emphysema are clinical entities where free air is present within the confines of retropharyngeal space and mediastinum without obvious cause. It is benign and self-limited in nature and allows for conservative management. This case is presented with a review of literature.

Keywords: Mediastinal Emphysema; Mediastinitis; Subcutaneous Emphysema.

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Conflict of interest statement

No potential conflict of interest relevant to this article was reported.

Figures

Fig. 1.
Fig. 1.
Lateral radiography of neck demonstrated a linear air-column (arrow) in the retropharyngeal space. Note the metal shadow between C1 and C2 spine is patient’s ear ring.
Fig. 2.
Fig. 2.
Computed tomography confirmed extensive cervical emphysema involving the retropharyngeal space (A: arrow) and mediastinum (B: arrows) with no evidence of fluid collection or abscess formation. (A) Axial image at the level of hypopharynx. (B) Axial image at the level of mediastinum.
Fig. 3.
Fig. 3.
Near-complete resolution of linear air column (arrow) in the retropharyngeal space was confirmed with radiography of lateral neck on the second hospital day.
See this image and copyright information in PMC

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