Abstract
Spontaneous pneumomediastinum (SPM) is a rare, self-limiting condition that can be complicated by pneumothorax, pneumopericardium, and subcutaneous emphysema. This case describes a 25-year-old man with a chronic marijuana use history who developed SPM after a recent respiratory infection. Imaging showed significant pneumomediastinum, pneumopericardium, and small pneumothoraces bilaterally. Despite these findings, he remained stable and was treated conservatively with oxygen supplementation, analgesics, and close monitoring. By day 6, his condition had nearly resolved, and he was safely discharged. This case emphasizes the importance of considering SPM in young patients with acute respiratory distress and reinforces the value of computed tomography scans in promptly diagnosing and managing the condition without invasive interventions.