Definition and research guide
This page combines a MeSH definition, publication statistics and selected research abstracts. It is a starting point for reading the literature, not a medical textbook or a systematic evidence review.
Content available: 4 complete abstracts (594 words), 10 references. Full article text is not stored or reproduced here; follow the PMID, DOI or PMC links to read the original sources and their access terms.
Definition
Presence of air in the mediastinal tissues due to leakage of air from the tracheobronchial tree, usually as a result of trauma.
Definition: NLM Medical Subject Headings (MeSH) scope note (Public domain (U.S. National Library of Medicine); attribution requested). View the MeSH record.
Also known as: Mediastinal Emphysemas; Emphysema, Mediastinal; Pneumomediastinum; Pneumomediastinums; Pulmonary Interstitial Emphysema; Emphysema, Pulmonary Interstitial; Emphysemas, Pulmonary Interstitial; Interstitial Emphysema, Pulmonary.
Where it fits in the MeSH classification
- Broader topics
- Mediastinal Diseases; Emphysema
Research landscape
PubMed indexes 4,141 records tagged with the MeSH heading “Mediastinal Emphysema” (counts retrieved 2026-11-04). 580 of them (14.0%) were published from 2020 onward, and the busiest period so far is through 1999 with 1,974 records.
Reviews account for 241 records (5.8%) and meta-analyses for 4. Randomized controlled trials number 2 (0.0%) as a share of all records on the topic. Randomized trials make up only a small share of this literature, so much of what is known comes from laboratory, observational or descriptive work.
Show the data
| Period | Records |
|---|---|
| through 1999 | 1,974 |
| 2000-2009 | 709 |
| 2010-2019 | 878 |
| 2020 onward | 580 |
Publication-type chart data
| Type | Records | Share |
|---|---|---|
| Reviews | 241 | 5.8% |
| Meta-analyses | 4 | 0.1% |
| Randomized controlled trials | 2 | 0.0% |
Method: PubMed query "Mediastinal Emphysema"[MeSH Terms] with publication-type and date filters, retrieved 2026-11-04.
Reading the evidence in respiratory medicine
Research on airway and lung disease mixes lung-function tests, symptom diaries, imaging and hospital records, so what was measured and in whom matters as much as the result. Many conditions here, such as asthma and COPD, vary between people and over time, and exposure studies (smoking, pollution, workplace dust) show association rather than proof of cause. Nothing on this page is advice about treatment or inhalers; anyone with breathing difficulty should seek care from a qualified clinician. Check how the condition was defined, the severity of the people studied and whether outcomes were symptoms, lung function or hospital admissions.
Evidence from open-access studies
These open-access studies come from PubMed’s best-match results for this heading (papers whose main topic it is), ranked here by citation count, with one recent addition. Each abstract is reproduced in full under its recorded open licence so that you can read the authors’ own words. They illustrate the literature; they are not a systematic summary of it. Citation counts measure attention, not reliability or clinical benefit.
| Study / authors | Year | Source label / design | Europe PMC citations | Licence / source |
|---|---|---|---|---|
| Case Report: Pneumothorax and Pneumomediastinum as Uncommon Complications of COVID-19 Pneumonia-Literature Review | 2020 | Review article Design not recorded in structured metadata | 62 | cc by PMID 32705978 · DOI · PMC7470555 |
| Spontaneous pneumomediastinum, pneumopericardium, pneumothorax and subcutaneous emphysema in patients with COVID-19 pneumonia, a case report | 2020 | Research article Design not recorded in structured metadata | 25 | cc by PMID 33028398 · DOI · PMC7538537 |
| Spontaneous pneumomediastinum on bedside ultrasound: case report and review of the literature | 2015 | Review article Design not recorded in structured metadata | 22 | cc by PMID 25834681 · DOI · PMC4380390 |
| Clinical impact of pneumomediastinum in patients with myositis-associated interstitial lung disease | 2025 | Research article Design not recorded in structured metadata | 4 | cc by PMID 40644484 · DOI · PMC12250632 |
Case Report: Pneumothorax and Pneumomediastinum as Uncommon Complications of COVID-19 Pneumonia-Literature Review [1]
Abstract reading summary — source excerpts
- Opening excerpt
- As the COVID-19 pandemic progresses, awareness of uncommon presentations of the disease increases.
- Closing excerpt
- Thus, it is necessary to pay attention to these complications as early identification and management can reduce the associated morbidity and mortality.
- Interpretation limits
- Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (169 words)
As the COVID-19 pandemic progresses, awareness of uncommon presentations of the disease increases. Such is the case with pneumothorax and pneumomediastinum. Recent evidence suggested that these can occur in the context of COVID-19 pneumonia, even in the absence of mechanical ventilation-related barotrauma. We present two patients with COVID-19 pneumonia complicated by pneumomediastinum. The first patient was a 55-year-old woman who developed COVID-19 pneumonia. Her clinical course was complicated by pneumothorax and pneumomediastinum, and, unfortunately, she died 2 days following the admission. The second patient was a 31-year-old man who developed a small pneumomediastinum and was managed conservatively. He had a spontaneous resolution of the pneumomediastinum and was discharged 19 days later. None of our patients required invasive or noninvasive positive pressure ventilation. We performed a literature review of COVID-19 pneumonia cases that developed pneumothorax, pneumomediastinum, or both. The analysis showed that the latter had high mortality (60%). Thus, it is necessary to pay attention to these complications as early identification and management can reduce the associated morbidity and mortality.
Abstract reproduced from the open-access article under the recorded cc by licence; © the authors. PMID 32705978 · DOI · PMC7470555
Spontaneous pneumomediastinum, pneumopericardium, pneumothorax and subcutaneous emphysema in patients with COVID-19 pneumonia, a case report [2]
Abstract reading summary — source excerpts
- Opening excerpt
- BackgroundSpontaneous pneumomediastinum unrelated to mechanical ventilation is a newly described complication of COVID-19 pneumonia.
- Closing excerpt
- Further studies are needed to determine risk factors and laboratory data predictive of development of spontaneous pneumomediastinum in COVID-19 pneumonia.
- Interpretation limits
- Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (134 words)
BackgroundSpontaneous pneumomediastinum unrelated to mechanical ventilation is a newly described complication of COVID-19 pneumonia. The objective of this case presentation is to highlight an important complication and to explore potential predisposing risk factors and possible underlying pathophysiology of this phenomenon.Case presentationWe present two patients with COVID-19 pneumonia complicated by spontaneous pneumomediastinum, pneumopericardium, pneumothorax and subcutaneous emphysema without positive pressure ventilation. Both patients had multiple comorbidities, received a combination of antibiotics, steroids and supportive oxygen therapy, and underwent routine laboratory workup. Both patients then developed spontaneous pneumomediastinum and ultimately required intubation and mechanical ventilation, which proved to be challenging to manage.ConclusionsSpontaneous pneumomediastinum is a serious complication of COVID-19 pneumonia, of which clinicians should be aware. Further studies are needed to determine risk factors and laboratory data predictive of development of spontaneous pneumomediastinum in COVID-19 pneumonia.
Abstract reproduced from the open-access article under the recorded cc by licence; © the authors. PMID 33028398 · DOI · PMC7538537
Spontaneous pneumomediastinum on bedside ultrasound: case report and review of the literature [3]
Abstract reading summary — source excerpts
- Opening excerpt
- Spontaneous pneumomediastinum is a rare disease process with no clear etiology, although it is thought to be related to changes in intrathoracic pressure causing chest pain and dyspnea.
- Closing excerpt
- We present a case report on ultrasound-diagnosed pneumomediastinum, and we review the diagnostic modalities to date.
- Interpretation limits
- Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (95 words)
Spontaneous pneumomediastinum is a rare disease process with no clear etiology, although it is thought to be related to changes in intrathoracic pressure causing chest pain and dyspnea. We present a case of a 17-year-old male with acute chest pain evaluated initially by bedside ultrasound, which showed normal lung sliding but poor visualization of the parasternal and apical cardiac views due to significant air artifact, representing air in the thoracic cavity. The diagnosis was later verified by chest radiograph. We present a case report on ultrasound-diagnosed pneumomediastinum, and we review the diagnostic modalities to date.
Abstract reproduced from the open-access article under the recorded cc by licence; © the authors. PMID 25834681 · DOI · PMC4380390
Clinical impact of pneumomediastinum in patients with myositis-associated interstitial lung disease [4]
Abstract reading summary — source excerpts
- Opening excerpt
- BackgroundIdiopathic inflammatory myositis (IIM) frequently coexists with interstitial lung disease (ILD), significantly impacting morbidity and mortality.
- Closing excerpt
- ConclusionSpontaneous pneumomediastinum is an independent risk factor for mortality in patients with myositis-associated ILD.
- Interpretation limits
- Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (196 words)
BackgroundIdiopathic inflammatory myositis (IIM) frequently coexists with interstitial lung disease (ILD), significantly impacting morbidity and mortality. Spontaneous pneumomediastinum, a complication of myositis-associated ILD, remains understudied regarding its clinical implications.MethodWe retrospectively reviewed patients diagnosed with myositis-associated ILD at Asan Medical Center, Seoul, South Korea, from April 2012 to September 2023. Patients were categorized into two groups based on the presence or absence of spontaneous pneumomediastinum during the follow-up period.ResultsAmong the 70 patients included in the study, the median age was 55.9 ± 12.2 years, with 62.9% being female. Pneumomediastinum developed in 12 (17.1%) patients. Clinical characteristics did not significantly differ between the pneumomediastinum and non-pneumomediastinum groups, except for the subtype of IIM. Notably, pneumomediastinum was observed in 11 (91.7%) patients with dermatomyositis and 1 (8.3%) with anti-synthetase syndrome (ASS), but none with polymyositis. Multivariate analysis revealed pneumomediastinum as a significant risk factor for mortality (hazard ratio: 2.829, 95% confidence interval: 1.100-7.270, p = 0.031) after adjusting for other variables. Patients with pneumomediastinum exhibited worse survival compared with patients without pneumomediastinum (median survival time: 77.7 ± 11.7 vs. 13.6 ± 3.7 months, p = 0.013).ConclusionSpontaneous pneumomediastinum is an independent risk factor for mortality in patients with myositis-associated ILD.
Abstract reproduced from the open-access article under the recorded cc by licence; © the authors. PMID 40644484 · DOI · PMC12250632
Key reviews and meta-analyses
The most cited review-type papers among PubMed’s best-match results for this heading, listed with bibliographic details only. Follow the links for the full text and access terms.
- Research article Subcutaneous and mediastinal emphysema. Pathophysiology, diagnosis, and management [5]
- Research article Spontaneous pneumomediastinum: a comparative study and review of the literature [6]
- Research article Spontaneous pneumomediastinum in children [7]
- Research article Pneumomediastinum in interstitial lung disease associated with dermatomyositis and polymyositis [8]
- Research article Pneumomediastinum in dermatomyositis: association with cutaneous vasculopathy [9]
- Research article Spontaneous pneumomediastinum, pneumothorax and subcutaneous emphysema in COVID-19 pneumonia: a rare case and literature review [10]
References
- Quincho-Lopez A, Quincho-Lopez DL, Hurtado-Medina FD. Case Report: Pneumothorax and Pneumomediastinum as Uncommon Complications of COVID-19 Pneumonia-Literature Review. . 2020. PMID 32705978 · DOI · PMC7470555
- Hazariwala V, Hadid H, Kirsch D, Big C. Spontaneous pneumomediastinum, pneumopericardium, pneumothorax and subcutaneous emphysema in patients with COVID-19 pneumonia, a case report. . 2020. PMID 33028398 · DOI · PMC7538537
- Zachariah S, Gharahbaghian L, Perera P, Joshi N. Spontaneous pneumomediastinum on bedside ultrasound: case report and review of the literature. . 2015. PMID 25834681 · DOI · PMC4380390
- Jung J, Kim MJ, Yoo B, Lee CK, Kim YG, Hong S, et al.. Clinical impact of pneumomediastinum in patients with myositis-associated interstitial lung disease. . 2025. PMID 40644484 · DOI · PMC12250632
- Maunder RJ, Pierson DJ, Hudson LD. Subcutaneous and mediastinal emphysema. Pathophysiology, diagnosis, and management. Arch Intern Med. 1984. PMID 6375617 · DOI
- Caceres M, Ali SZ, Braud R, Weiman D, Garrett HE. Spontaneous pneumomediastinum: a comparative study and review of the literature. Ann Thorac Surg. 2008. PMID 18721592 · DOI
- Chalumeau M, Le Clainche L, Sayeg N, Sannier N, Michel JL, Marianowski R, et al.. Spontaneous pneumomediastinum in children. Pediatr Pulmonol. 2001. PMID 11180677 · DOI
- Le Goff B, Chérin P, Cantagrel A, Gayraud M, Hachulla E, Laborde F, et al.. Pneumomediastinum in interstitial lung disease associated with dermatomyositis and polymyositis. Arthritis Rheum. 2009. PMID 19116970 · DOI
- Kono H, Inokuma S, Nakayama H, Suzuki M. Pneumomediastinum in dermatomyositis: association with cutaneous vasculopathy. Ann Rheum Dis. 2000. PMID 10784520 · DOI · PMC1753137
- Elhakim TS, Abdul HS, Pelaez Romero C, Rodriguez-Fuentes Y. Spontaneous pneumomediastinum, pneumothorax and subcutaneous emphysema in COVID-19 pneumonia: a rare case and literature review. BMJ Case Rep. 2020. PMID 33310838 · DOI · PMC7735137
About this article
- Sources
- NLM Medical Subject Headings (definition, synonyms); NCBI PubMed (counts, identifiers); Europe PMC (open-access abstracts and citation counts).
- Verification
- Every reference was resolved against PubMed on 2026-11-04; title, year and DOI matched.
- Review state
- automated source verified; no human expert review has been recorded yet.
- Version
- 1, last updated 2026-11-04.
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Evidence strength
EvidenceHelix's computed view of the study designs behind this topic: how common meta-analyses, randomized trials and reviews are, how recent the literature is, and a plain-language reading. It describes the design mix of the literature. It is not a quality appraisal of any study, and it is not medical advice.