[Soft-tissue cervicofacial emphysema and pneumomediastinum caused by self injury].

A prison inmate was referred to us for diagnostic procedures and therapy due to a combination of pneumomediastinum with emphysema of neck and face. External injuries were absent and pathogenesis remained uncertain until thorough examination of the patient revealed two intraoral wounds, presumably from a needle, reaching into the maxillary sinus. This large subcutaneous emphysema of the face, neck and mediastinum was the result of an exaggerated Valsalva maneuver. With this self-inflicted injury, unknown to us, the prisoner achieved the desired immediate admission to hospital.