A Case of Pneumomediastinum and Pneumorrhachis in a Patient With Multiple Risk Factors

Pneumomediastinum is the presence of gas (usually air) in the mediastinum, which is rare and typically benign. Pneumomediastinum is classified into primary and secondary based on etiology. Its pathophysiology is due to high intra-alveolar pressures causing alveolar rupture, which releases air that travels along bronchoalveolar sheaths into the mediastinum. Pneumomediastinum may also be concurrently seen with pneumorrhachis defined as air in the spinal canal, although this finding is rare. Here, we present the case of a 27-year-old male with a past medical history of polysubstance use and a one-week history of nausea, vomiting, and chest pain who presented with frostbite and was found to have pneumomediastinum and pneumorrhachis.