ABSTRACT

The spontaneous pneumomediastinum is characterized by the air presence in the mediastinum. It is a generally benign disease which evolves in a satisfactory way between 2 and 15 days, that is not associated to any directly known cause. It is infrequent in the old age. It mainly presents with chest pain, dyspnea and subcutaneous emphysema. Diagnosis realizes on the base of clinical characteristics, thorax radiography and thorax axial computed tomography, being the last one also important to establish the differential diagnosis with Boerhaave syndrome in an opportune way. The case presented is the case of a male patient aged 67 years, who smokes and has antecedents of chronic obstructive pulmonary disease. He assisted to the consultation due to thoracic pain, dyspnea and subcutaneous emphysema after an episode of intense cough. Posteroanterior and lateral thorax radiography were done, finding air presence in the mediastinum; other acute diseases were discarded and the diagnosis of pneumomediastinum was corroborated through thorax computed tomography scan. He was treated with oxygen, bronchodilators, steroids and antibiotics therapy, obtaining an evident improvement. The literature reports that the presence of these characteristics in old-aged patients is not common and that it must be suspected in those presenting an aggravation of the chronic obstructive pulmonary disease, mainly after a cough episode.

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