Abstract
Dear editor, we read with great interest the two recent case reports about pneumomediastinum: “Com-pli cated pulmonary interstitial emphysema” reported by C. Altay (JBR-BTR, 2011, 94: 84) and “Spon - taneous soccer-induced pneumo - mediastinum in a 39-year-old man” reported by K. De Smet (JBR-BTR, 2011, 346-347). We would like to widen this subject, reporting a case of massive spontaneous pneumomediastinum by Macklin effect in a 25-year-old man. High quality MDCT series, associated to scientific literature review, allow us to highlight the the CT appearance of the Macklin effect leads us to affirm the spontaneous orgin of the pneumomedia - stinum and thus permitting to be reassuring