Background: Spontaneous pneumomediastinum (PM) is a rare benign disease entity in children with several predisposing factors. This study reports a case of spontaneous PM related to the use of electronic cigarettes (e-cigarettes) in a 17-year-old adolescent. Case Presentation: A 17-year-old male, user of e-cigarettes, with no underlying pulmonary disease presented to the emergency department with acute chest pain, without any preceding events including trauma. His physical examination was unremarkable apart from positive Hamman’s crunch. A plain chest X-ray showed PM and left-sided apical pneumothorax. Chest computed tomography confirmed the presence of PM, accompanied by pneumopericardium and bilateral apical pneumothoraces. The patient reported the use of e-cigarettes, and he was admitted and conservatively managed in the hospital and discharged after three uneventful days. In this case, smoking e-cigarettes was the only predisposing factor found to be associated with the development of spontaneous PM. Conclusion: Emergency physicians should consider the diagnosis of spontaneous PM in adolescents who are presenting with acute chest pain, and e-cigarette smoking could be a precipitating factor.

Keywords: Pneumomediastinum, emergency department, electronic cigarettes, pediatric, chest pain.