CTICasesAnterior Abdominal wall and Retroperitoneal Air Dissection from Pneumomediastinum
Imaging findings
CT chest and abdomen shows extensive pneumomediastinum, with gas dissecting through the sternocostal triangles (foramen of Morgagni) into the anterior abdominal wall and retroperitoneum (posterior pararenal space), without evidence of hollow viscus perforation.
Key takeaways
Mediastinal gas can dissect along anatomically contiguous facial planes. It can track superiorly into the neck or inferiorly through the diaphragmatic openings into the retroperitoneal space and anterior abdominal wall. Recognizing this benign pathway is important to avoid a misdiagnosis of intra-abdominal catastrophe.
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