Fish bone associated pneumomediastinum in a 15-year-old adolescent male.

Abstract

A 15-year-old boy who had been experiencing chest tightness and odynophagia for 6 h came to the emergency department. He swallowed a salmon bone 12 h earlier. The vital signs at triage did not indicate tachypnea or desaturation. The patient appeared well on physical examination. He had a patent oropharynx and crepitus felt over his right supraclavicular area. His respiratory pattern was smooth, and his breath sounds were symmetric and clear bilaterally. A chest radiograph revealed lucent streaks of gas outlining mediastinal structures with an extension of subcutaneous emphysema and pneumopericardium (Fig. 1a).