What’s your approach to an asymptomatic, hemodynamically stable patient with moderate spontaneous pneumomediastinum without pneumothorax and normal esophagogram?  

Terrific question and, fortunately, an unusual occurrence with an estimated 1 in 30,000 hospital admissions (Barroso et al., PMID 37965408). The true incidence is likely higher as underdiagnosis may be related to individuals with mild symptoms who do not seek medical care, symptoms misdiagnosed and ...