Air. It’s generally considered a pretty good idea. A fundamental aspect of aerobic metabolism and an essential need for most organisms on earth, it’s safe to say that life without air for a human isn’t much of a life at all. But what happens when air starts making mischief? What happens when air shirks the restrictive confines of the alveoli and elects instead to explore the muscle and subcutaneous tissue, seeks to admire the heart and great vessels, opts to race unencumbered along fascial planes and aponeuroses - what do you have then?

Well, a pneumomediastinum for one. In his article, Dr. Skrobut does a breathtaking job of detailing the presentation of a young patient with spontaneous pneumomediastinum, delving into the diagnostic modalities of choice, its emergent management, and the longterm prognosis. His article also seeks to clear the air about more controversial topics, including the role of empiric antibiotics and the need for surgical intervention.