Virtual Pediatric Hospital(tm) : A digital library of pediatric information

Home | About | FAQ | Reviews | Search

Virtual Pediatric Hospital: Paediapaedia: Pneumomediastinum (PMS) Paediapaedia: Neonatal Chest Diseases

Pneumomediastinum (PMS)

Michael P. D'Alessandro, M.D.
Peer Review Status: Internally Peer Reviewed

Clinical Presentation:
Respiratory distress, often minimal.

In the newborn, the periphery of the lung is hyperinflated. Due to uneven distention of alveoli and poorly developed collateral air channels, a pressure gradient develops between the alveoli and the interstitial spaces. This causes alveoli to rupture into the interstitium, with air then extending into the interstitium and then dissecting centrally to the hila and mediastinum along the perivascular sheaths/bronchovascular bundles. The pneumomediastinum may extend under the diaphragm by dissecting along the esophageal hiatus and other diaphragmatic foramina. Air can accumulate in the retroperitoneum or dissect peripherally through the mesenteric perivascular spaces to rupture into the peritoneal cavity. Air can dissect upward into the neck as well. Spontaneous pneumomediastinum usually only causes minimal respiratory distress and resolves with conservative therapy. Non spontaneous pneumomediastinum is most often due to air leak complications in patients on mechanical ventilation.

Not applicable.

Imaging Findings:
Air is seen in the mediastinum, usually collecting in the anterior and middle mediastinum. icon gif The thymus is often well outlined by the mediastinal air. A "continuous diaphragm sign" may be seen, with air in the retrocardiac space outlining the diaphragm under the heart. The continuous diaphragm sign may also be seen in pneumopericardium.


See References Chapter.

Section Top | Title Page

Additional pediatric resources: | Facebook iconTwitter iconRSS icon |

Follow us on Twitter @pedseducationTwitter icon and @pedsimagingTwitter icon and Facebook @pedsimagingFacebook icon and Instagram @pedsimagingInstagram icon

About Us | FAQ | Reviews | Contact Us | Search

Virtual Pediatric Hospital is curated by Donna M. D'Alessandro, M.D. and by Michael P. D'Alessandro, M.D.

Please send us comments by filling out our Comment Form.

All contents copyright © 1992-2016 Donna M. D'Alessandro, M.D. and Michael P. D'Alessandro, M.D. and the authors. All rights reserved.

"Virtual Pediatric Hospital", the Virtual Pediatric Hospital logo, and "A digital library of pediatric information" are all Trademarks of Donna M. D'Alessandro, M.D. and Michael P. D'Alessandro, M.D.

Virtual Pediatric Hospital is funded in whole by Donna M. D'Alessandro, M.D. and Michael P. D'Alessandro, M.D. Advertising is not accepted.

Your personal information remains confidential and is not sold, leased, or given to any third party be they reliable or not.

The information contained in Virtual Pediatric Hospital is not a substitute for the medical care and advice of your physician. There may be variations in treatment that your physician may recommend based on individual facts and circumstances.