Pneumomediastinum Secondary to Corn Chip Ingestion
Case Presentation
A 14 year old male presented to the pediatric emergency department with a 4 h history of neck and chest pain. The patient was running between classes and choked while eating a “Doritos” chip. He immediately felt a throat pain that worsened with swallowing and subsequently a chest pain. He denied hoarseness, shortness of breath or dyspnea. On physical examination, the patient was alert, active, in no acute distress, spoke in full sentences and his vital signs were normal and stable. A crepitus was noted over the left anterior and lateral cervical areas, left axilla and left hemithorax, with no tenderness or focal findings. Chest and Neck X-rays were performed and showed a PM with a small focus of soft tissue gas in the right axilla and an anterior cervical soft tissue gas (Figures 1 and 2). The patient was admitted to the pediatric intensive care unit (PICU) for close monitoring and further management. Thoracic surgery and Otolaryngology were consulted and recommended an esophagogram that did not show any esophageal injury. The otolaryngologist performed a fiberoptic direct laryngoscopy that did not show any lesions. Throughout his hospitalization the patient had no signs of hemodynamic compromise, remained in no respiratory distress and a follow up chest X-ray showed mild improvement of the PM (Figure 3)......