Pneumomediastinum is not uncommon in paraquat poisoning and usually results from oesophageal perforation or alveolar rupture in fibrotic lung disease. However, the combined presentation of pneumomediastinum and pneumoperitoneum is a rarity. We recently managed a young patient with paraquat ingestion who developed spontaneous pneumomediastinum. His chest radiograph also showed free air under the right hemidiaphragm. This pneumoperitoneum caused no clinical symptom and resolved spontaneously within a few days without any surgical intervention.
KourounisGLimQXRashidT, et al.A rare case of simultaneous pneumoperitoneum and pneumomediastinum with a review of the literature. Ann R Coll Surg Engl2017; 99: e241–e243.
