A 12-year-old girl presents with some chest discomfort after playing soccer with her friends. She denies any trauma. She is hemodynamically stable. A chest x ray is performed and reveals a moderate pneumomediastinum. The best next step in her management should be

 

[center][/center]

 

 

 

[size=20px]A Bronchoscopy

 

B Esophagram

 

C Chest CT

 

D No further imaging​[/size]

A-Bronchoscopy

C

A - bronchoscopy

A- bronchoscopy

C

D

D

B

C

C

c

Correct answer

D No further imaging

 

Spontaneous pneumomediastinum is relatively common in children and is suspected to occur after rupture of alveoli following exhaling against a closed glottis, as may be experienced with coughing, vomiting, or strenuous activity. Patients often present with mild chest discomfort and coughing. Multiple reports have repeatedly shown no benefit in obtaining any further studies, including chest x ray, CT, or esophagram. Providers may choose to observe or discharge home.