Pneumomediastinum Causing Pneumoperitoneum

Pneumomediastinum is characterized by the presence of air in the mediastinum and has been recognized since 1827, when described by Laënnec. To the best of our knowledge, pneumoperitoneum as a result of spontaneous pneumomediastinum has not yet been described in the English literature. We observed and treated a young patient in the intensive care unit who presented with spontaneous pneumomediastinum. Free intra-abdominal gas was observed on the chest x-ray film on the day after admission. Management was conservative. Intra-abdominal and mediastinal air disappeared within four days. This condition, when recognized, needs only observation; we report this as a medical curiosity.