Idiopathic Spontaneous Pneumomediastinum in an Active Patient With Crohn's Disease.

Spontaneous pneumomediastinum (SPM) is a rare complication of inflammatory bowel disease (IBD), often associated with colonic perforations or procedural interventions. This report details a case of a 30-year-old female with ileocolonic Crohn's disease (CD) presenting with idiopathic SPM during an acute CD flare while on prolonged corticosteroid therapy. Imaging confirmed pneumomediastinum without evidence of esophageal or colonic perforation. Conservative management with supportive care and prophylactic antimicrobials led to clinical resolution. This case underscores the importance of recognizing SPM as a potential extraintestinal complication of CD, particularly in the context of prolonged steroid use.