Acute pneumomediastinum secondary to hydrogen peroxide therapy of upper right limb wound

Background: Pneumomediastinum, or mediastinal emphysema is defined by the presence of air or gas in the mediastinum. Although mediastinal emphysema due to benign causes is cured mainly conservatively, however, in cases of pneumomediastinum due to oesophageal or tracheobronchial rupture, surgical treatment is necessary and involves high morbidity and mortality. Method: Case report. Results: A male patient with clinical and radiological signs of acute pneumomediastinum and subcutaneous emphysema of anterior thoracic wall, without signs of infection, is presented. A wound in the right elbow, which was treated by irrigation of 10% hydrogen peroxide solution, was reported. Conservative treatment was decided with good final outcome. Conclusions: It is concluded that although pneumomediastinum carries potentially life-threatening differential diagnoses, urgent surgical treatment should be avoided when accurate diagnosis is not previously set.