Purpose or Case Report: Pneumomediastinum is a relatively common cause of hospitalization in the pediatric population. In this study, we evaluate the effect of chest CT on the management of spontaneous pneumomediastinum in the pediatric age group. If chest CT can be shown to have no significant effect on management, then radiation dose to the patient can be decreased.
Methods & Materials: We searched the hospital radiology database (RIS) for the word "pneumomediastinum" between September 2005 to March 2016. Medical record and imaging was reviewed. Patients with pneumothorax in addition to pneumomediastinum were not included.
Results: We found 14 pediatric patients with spontaneous, or non-traumatic, pneumomediastinum during this time period. Underlying causes included respiratory illness, asthma, drug overdose, extreme breath-holding and some truly idiopathic cases. All patients had at least one chest radiograph. 6 patients had chest CT in addition to a radiograph. Chest CT demonstrated pneumomediastinum in all patients but did not provide any additional information relative to the radiograph or clinical exam. The results of the chest CT therefore did not change management
Conclusions: Many pediatric patients with spontaneous pneumomediastinum are evaluated with chest CT. In our series, CT did not change patient management or outcome. In keeping with the surgical literature, we recommend against the routine use of CT to evaluate patients with spontaneous pneumomediastinum.