An unusual presentation of spontaneous pneumomediastinum.

Spontaneous pneumomediastinum is an uncommon disease that often presents with subtle clinical and radiographic findings. During a two-week period, three patients presented with complaints of throat and neck pain. The first complained of difficulty swallowing and throat and chest discomfort; accurate diagnosis was delayed because of the unusual presenting symptoms. The second had severe throat pain. The third presented with unstable vital signs, throat and neck pain, and air in the pericardium and mediastinum. Review of the first case facilitated the correct diagnosis of spontaneous pneumomediastinum in the subsequent cases. All three patients were discharged free of symptoms.