Postpartum pneumomediastinum and subcutaneous emphysema.

We present the case of a 22-year-old primigravida with symptoms of neck swelling and difficulty breathing 3 hours after uneventful vaginal delivery. On examination, there was surgical emphysema. A CT scan confirmed air in the subcutaneous tissues and also revealed pneumomediastinum. There was no evidence of pneumothorax and gastro-oesophageal endoscopy showed no signs of oesophageal rupture. The patient remained clinically stable throughout her admission and was discharged home after 48 hours of observation. Pneumomediastinum is one of the rare causes of shortness of breath and chest pain during the postpartum period, and it should be considered in the differential diagnosis. Despite the significant abnormalities seen on plain radiography and CT scan, this condition spontaneously resolves. Although postpartum pneumomediastinum has been related to prolonged labour, this was not the case in our patient. © BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.