A 19-year-old woman underwent an ovarian cyst operation. She was then diagnosed as ileus and as the case progressed, she was next diagnosed as spontaneous pneumomediastinum.
In our hospital, she underwent an adenexectomy and omentectomy. In the pathologic diagnosis, she was diagnosed as yolk sac tumor.
On postoperative day 13, she was given chemotherapy.
On the 9th day after her chemotherapy was started, she had abdominal distention and frequent vomiting. She was then diagnosed with mechanical ileus. At same time, she had subcutaneous emphysema over the right region of the buccalis and neck, and the region of the neck was palpable.
CT scan examination of neck and chest showed pneumatosis in the mediastinum.
A long intestinal tube was inserted, and her condition and pneumatosis in the mediastinum were improved.
Our case suggests that pneumatosis in the mediastinum was caused by pleural pressure increased by severe vomiting with postoperative ileus. We report the case with reference to the literature.