case_images: PMC8486495_01
case_images: Chest X-ray, taken at the time of admission, also shows pneumomediastinum (white arrow); the subcutaneous emphysema is also visible (black arrows).
case_images: 10-1055-s-0041-1731274-i210583cr-1.jpg
case_images: PMC8486495_01_10-1055-s-0041-1731274-i210583cr-1.jpg
case_images: FI210583cr-1
case_images: The chest X-ray showed pneumomediastinum ( Fig. 1 .).
case_images: Computed tomography scan (in the level of bifurcation) depicted an extensive subcutaneous emphysema and a huge pneumomediastinum (diameter: 10.8 cm): (
  A
  ) Transverse, (
  B
  ) sagittal, and (
  C
  ) coronal section.
case_images: 10-1055-s-0041-1731274-i210583cr-2.jpg
case_images: PMC8486495_01_10-1055-s-0041-1731274-i210583cr-2.jpg
case_images: FI210583cr-2
case_images: On the third day of hospitalization, she became tachypneic again; her oxygen requirement and the size of subcutaneous emphysema increased (neck, chest, and abdominal circumference increased, subcutaneous emphysema became palpable on the arms and the whole trunk); she felt like "a pillow pushing her back." An urgent chest CT scan was performed, which showed extensive subcutaneous emphysema and a huge pneumomediastinum ( Fig. 2 ).
case_images: The drains leading to the mediastinum via the jugular notch.
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case_images: PMC8486495_01_10-1055-s-0041-1731274-i210583cr-3.jpg
case_images: FI210583cr-3
case_images: Control computed tomography scan (after 11 days of the first one) depicted a significant improvement (4.3 cm). The arrows show the mediastinal drains.
case_images: 10-1055-s-0041-1731274-i210583cr-4.jpg
case_images: PMC8486495_01_10-1055-s-0041-1731274-i210583cr-4.jpg
case_images: FI210583cr-4
case_images: Eleven days later, the chest CT scan was repeated ( Fig. 4 ), which showed a significantly smaller pneumomediastinum.