Which of the following is least likely to cause pneumomediastinum?
a. Chest trauma
b. Esophageal rupture
c. Thyroid surgery
d. Pericarditis
ANS: D
Pneumomediastinum, is a form of barotrauma, may result from movement of air into the medias-tinum, as may also be seen in cases of esophageal rupture (Figure 21-30). This usually occurs in the distal portion of the esophagus in patients who undergo procedures to stretch or dilate the esophagus. Chest trauma may cause rupture of a main bronchus, also allowing movement of air into the mediastinum. Rarely, air dissects down from the soft tissues of the neck after thyroid, parathyroid, or tonsillar surgery. Gas associated with a retrotonsillar abscess may also move down to the mediastinum through the fascial planes of the neck. Air that accumulates in the retroperi-toneum may enter the mediastinum via openings in the diaphragm for the aorta or esophagus.
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