The authors present the case of a previously healthy, 22-year-old male nonsmoker who sought emergency room treatment complaining of retrosternal pain. He reported a history of odynophagia two days before, followed by productive cough, fever and dyspnea. On chest radiography, a line could be observed surrounding the heart and the continuous diaphragm sign. The chest computed tomography scan confirmed the presence of pneumomediastinum and soft tissue emphysema. The case was discussed in a multidisciplinary team, and the possibility of surgical intervention was rejected. Conservative treatment was decided with complete resolution of the pneumomediastinum.

Portuguese Journal of Cardiac Thoracic and Vascular Surgery, Vol. 27 No. 1 (2020): January - March