[The spontaneous mediastinal and skin emphysema].
A report is given on four patients with spontaneous mediastinal and skin emphysema. In three cases younger patients from 14 to 21 years were concerned, in the fourth case a 63-year-old patient was concerned. Two of the younger patients revealed a long lasting malnutrition. As favouring or triggering factor, respectively, for the pathogenesis of the mediastinal emphysema in accordance with Macklin an increase of the intrathoracic pressure by retching, pressing or vomiting is regarded. Apart from this a vasoconstriction of the alveolar vessels (due to decrease of the plasma volume) and nutritional disease might be of importance. In all patients the mediastinal and skin emphysema receded under symptomatic therapeutic measures within some days.