Pneumomediastinum After Inhalation of Helium Gas from Party Balloons
Received 30 January 2007; received in revised form 19 February 2007; accepted 22 February 2007. published online 19 November 2007.
Abstract
A previously healthy 16-year-old boy presented to the Emergency Department with a 2-day history of hoarseness, sore throat, and chest tightness. The physical examination was significant for diffuse neck and chest subcutaneous emphysema. A computed tomography (CT) scan of the neck and chest revealed pneumomediastinum after a plain chest X-ray study failed to uncover this finding. The patient reported that 5 days before presentation he forcefully inhaled helium gas directly from multiple party balloons in an attempt to alter his voice. The patient fully recovered over the next 2 days. Spontaneous pneumomediastinum developed in this patient with no underlying lung disease, presumably from air leakage secondary to the excessive elevation of intra-thoracic pressure due to repetitive inhalation of helium gas. Spontaneous pneumomediastinum remains largely underdiagnosed clinically, especially in young, healthy patients.
Department of Emergency Medicine, Alameda County Medical Center-Highland General Hospital, Oakland, California
Reprint Address: Brita E. Zaia, md, Department of Emergency Medicine, Alameda County Medical Center-Highland General Hospital, 1411 East 31st Street, Oakland, CA 94602