Abstract
CASE REPORT A 76yearold male was brought to our emergency department with a 10day history of shortness of breath on exertion despite longterm oxygen therapy (1.0 L/min continuously). He complained of mild precordial discomfort, which was aggravated by movement. He had emphysema and a past medical history of pneumothorax, tuberculosis, gallstone surgery, and surgery for stomach cancer in 1987. He was in chronic distress and appeared emaciated. This laboratory examinations were as follows blood pressure 102/56 mmHg, heart rate 92 bpm, respiratory rate 28 bpm, body temperature 37.2°C. Oxygen saturation was 100% at a flow rate of 1.0 L/min. There were no audible rales in the chest. Blood tests showed a low concentration of serum albumin (3.1 g/dL). There were no electrocardiogram changes. Chest radiography demonstrated residual scarring from tuberculosis and mild pneumomediastinum. Computed tomography (CT) scan of chest demonstrated that the pneumomediastinum was limited mainly to the mediastinal tissues to the left of the trachea. The day after admission we confirmed that the pneumomediastinum was improving by chest Xray and CLINICAL IMAGE OPEN ACCESS
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