What is the prognosis of pneumomediastinum?

Updated: Apr 28, 2020
  • Author: Brian J Daley, MD, MBA, FACS, FCCP, CNSC; Chief Editor: Mary C Mancini, MD, PhD, MMM  more...
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Pneumomediastinum is generally a benign, self-limited condition. Malignant pneumomediastinum, or tension pneumomediastinum (unvented mediastinal or pulmonary adventitial air causing pressure so high that circulatory or ventilatory failure occurs), was first described in 1944; however, all patients described in this report had serious comorbid conditions, often related to trauma or in association with Boerhaave syndrome.

No reports of fatal outcomes in patients with spontaneous pneumomediastinum in the absence of underlying disease exist in the more recent literature. The mortality rate is as high as 70% in patients with pneumomediastinum secondary to Boerhaave syndrome, even with surgical intervention. Traumatic mediastinum, although present in up to 6% of patients does not portend serious injury. [33]

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