• Steven Kelly, Stephanie Hughes, Stephen Nixon, and Simon Paterson-Brown.
• Oxford Clinic, Level 1, 38 Oxford Terrace, Christchurch, New Zealand. stevenkelly@clear.net.nz
• Surg J R Coll Surg E. 2010 Apr 1; 8 (2): 63-6.

IntroductionSpontaneous pneumomediastinum is defined as the presence of free air in the mediastium in the absence of any obvious precipitating cause. The purpose of this study was to review our experience with this condition, discuss mechanisms and provide a management algorithm.MethodsA retrospective audit of patients admitted with spontaneous pneumomediastinum between 2003 and 2008 was performed. A total of 17 patients were identified.ResultsCommon predisposing factors for spontaneous pneumomediastinum were alcohol excess, asthma and illicit drug use. Vomiting and coughing were common precipitating factors. There was no morbidity, mortality or recurrence. Patients were admitted under a number of different specialties.DiscussionSpontaneous pneumomediastinum is a benign self-limiting condition that requires early differentiation from more serious causes, in particular Boerhaave's syndrome.Copyright 2009 Royal College of Surgeons of Edinburgh (Scottish charity number SC005317) and Royal College of Surgeons in Ireland. All rights reserved.

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