Spontaneous pneumomediastinum (SPM) is a rare and usually self-limiting condition that may occur in young and otherwise healthy individuals, often after activities that cause a sudden rise in intrathoracic pressure. We present the case of a 21-year-old man who developed acute throat pain and difficulty swallowing immediately following intense weightlifting. Physical examination was suggestive of cervical subcutaneous emphysema, and imaging confirmed pneumomediastinum without evidence of esophageal or airway injury. The patient was managed conservatively with rest, analgesics, supplemental oxygen, and observation, resulting in rapid symptom improvement and complete radiologic resolution. This case highlights the need to consider SPM in patients presenting with chest or neck symptoms after strenuous physical activity, as early recognition supports appropriate conservative management and helps avoid unnecessary invasive interventions.
Elhag et al. (2026) studied this question.