The discovery of pneumomediastinum following blunt trauma is a source of great consternation for trauma surgeons because pneumomediastinum comes in 2 forms: the one that you do not have to worry about and the other that is really bad and that you do need to worry about. Fortunately, most cases are the former. Nevertheless, to date, there are no distinguishing features on a computed tomographic scan that can help one to decipher whether the pneumomediastinum is concerning and justifies a myriad of diagnostic studies and close observation in the intensive care unit, or whether the pneumomediastinum is a benign, incidental finding.
de Virgilio C, Kim DY. Pneumomediastinum Following Blunt TraumaAre We Closer to Unlocking Its Significance?. JAMA Surg. 2015;150(8):762-763. doi:10.1001/jamasurg.2015.1146