Pneumomediastinum: A Rare Complication of Endobronchial Ultrasound Guided Fine Needle

Endobronchial ultrasound guided transbronchial needle aspiration (EBUS-TBNA) is a commonly performed outpatient procedure used for the diagnosis, staging of lung cancer, and the evaluation of thoracic lymphadenopathy of unknown origin. With the advent of this minimally invasive technology, mediastinoscopy, once the gold standard, has fallen out of favour. Pneumomediastinum is a rare complication of EBUS-TBNA and can often be managed conservatively. We present a case of a 52-year-old female who developed pneumomediastinum following EBUS-TBNA and improved with expectant management in the emergency department. We discuss the proposed pathophysiology of this rare occurrence that usually follows a benign course. Severe complications, such as mediastinitis and tracheal tear, need to be excluded promptly.