Tension pneumomediastinum: A literal form of chest tightness

Abstract

Tension pneumomediastinum is a rare and life-threatening complication of mediastinal emphysema which can occur with mechanical ventilation. We present a case of tension mediastinum associated with mechanical ventilation in a patient with Acute Respiratory Distress Syndrome due to <i>Pneumocystis jirovecii</i> pneumonia. We discuss the mechanism and pathophysiology of tension pneumomediastinum, the potential association with <i>Pneumocystis jirovecii</i> pneumonia and recruitment manouvres, and its definitive emergency treatment.