# Idiopathic Spontaneous Pneumomediastinum in an Active Patient With Crohn’s Disease

## TL;DR

A 30-year-old woman with Crohn’s disease developed a rare lung condition without clear cause, likely linked to her disease flare and steroid use.

## Contribution

Highlights idiopathic pneumomediastinum as a possible extraintestinal complication of Crohn’s disease during steroid therapy.

## Key findings

- Pneumomediastinum occurred without evidence of perforation in a Crohn’s patient during a flare.
- Conservative treatment resolved the condition, suggesting non-surgical management is viable in select cases.

## Abstract

Spontaneous pneumomediastinum (SPM) is a rare complication of inflammatory bowel disease (IBD), often associated with colonic perforations or procedural interventions. This report details a case of a 30-year-old female with ileocolonic Crohn’s disease (CD) presenting with idiopathic SPM during an acute CD flare while on prolonged corticosteroid therapy. Imaging confirmed pneumomediastinum without evidence of esophageal or colonic perforation. Conservative management with supportive care and prophylactic antimicrobials led to clinical resolution. This case underscores the importance of recognizing SPM as a potential extraintestinal complication of CD, particularly in the context of prolonged steroid use.