This chest CT looks terrifying, but it was not caused by trauma or surgery. This is a published case of spontaneous pneumomediastinum with subcutaneous emphysema in a healthy young man. The mechanism is a sudden rise in pressure inside the chest causing air to leak from the lungs into the mediastinum and soft tissues, known as the Macklin effect. Rare, dramatic on imaging, and often self limiting, but serious causes must always be ruled out. Follow for clear, evidence based medical explanations.
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