Pneumomediastinum post amphetamine smoking

Case contributed by Dr Chris O'Donnell

Presentation

Smoking amphetamines (ice), now central chest pain. Palpable subcutaneous emphysema.

Patient Data

Gender: Male

Marked subcutaneous emphysema is associated with marked pneumomediastinum, pneumopericardium, small bilateral pneumothoraces and even extradural spinal gas. No apical lung bullae/blebs and no signs of rib/lung trauma.

Case Discussion

Gas is presumed to originate from rupture of alveolar sacs into the lung intestitium, thus into the pleural spaces and mediastinum. Reason for rupture might well be high alveolar pressures generated by forced Valvslava manoeuvres (to enhance absorption of the drug) or vomiting as a side effect of the drug(s).

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Case information

rID: 28553
Case created: 30th Mar 2014
Last edited: 20th Nov 2015
System: Chest
Inclusion in quiz mode: Included

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