Sore throat may be a clue to the early diagnosis of spontaneous pneumomediastinum.

Spontaneous pneumomediastinum is defined as presence of air in the mediastinum without obvious cause such as esophageal perforation or abscess formation. It is a benign condition and usually resolved by itself in 1 to 2 weeks. The main symptom of spontaneous pneumomediastinum is retrosternal chest pain. Here, we present a young adult who complained about sore throat initially. Marked retropharyngeal emphysema was noted by neck x-ray. Pneumomediastinum was confirmed with chest x-ray and computed tomographic scan later on.We want to emphasize the importance of thorough history taking and lateral soft tissue neck radiograph on retropharyngeal emphysema in real time, which is key to the diagnostic workup for patients who present with persistent sore throat and dysphagia in young adult.