• Jonathan G Chang, Lyndsay S Fisher, and Deepak Choudhary.
• Division of Pediatric Emergency Medicine, Department of Pediatrics, University of Arkansas Medical Sciences, Little Rock and Arkansas and Arkansas Children's Hospital, Little Rock, Arkansas.
• J Emerg Med. 2021 Nov 1; 61 (5): e116-e119.

BackgroundPneumorrhachis is an uncommon radiographic finding and is typically found in adult patients secondary to trauma or pneumocephalus. It is extremely rare in the pediatric population. Our case report describes a young boy who was found to have pneumorrhachis, but initially presented with an isolated back laceration.Case ReportAn 8-year-old boy arrived to the emergency department as a transfer from an outside hospital after initially presenting with a back laceration. After laceration repair, he developed severe headache and vomiting when sitting upright from a supine position. He was found to have T3 fractures and pneumocephalus secondary to pneumorrhachis and was managed conservatively per neurosurgery recommendations. Why Should an Emergency Physician Be Aware of This?Although extremely rare in the pediatric population, pneumorrhachis must still be considered in any pediatric patient with a penetrating injury to the abdomen, respiratory tract, or spinal column. Cases without clear etiology require further evaluation for occult spinal injuries and fractures. Conservative management is typically sufficient, although certain situations require further intervention.Copyright © 2021 Elsevier Ltd. All rights reserved.

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