A Rare Case of Vaping-Induced Spontaneous Pneumomediastinum

Abstract

Vaping is the process of inhaling an aerosol produced by heating a liquid or wax containing substances such as nicotine, cannabinoids (e.g., tetrahydrocannabinol, cannabidiol), flavoring, and additives (e.g., glycerol, propylene glycol). The presence of air or gas in the mediastinum is pneumomediastinum.We present a rare case of vaping-induced spontaneous pneumomediastinum. A young 20-year-old female patient with a history of vaping and no past medical history presented with acute chest pain to an emergency room. The urine drug screen was positive for cannabinoids. Imaging studies -chest x-ray and computed tomography of the chest -showed pneumomediastinum. The patient was discharged after a day of observation and counseling to quit vaping.

Electronic Cigarette or Vaping-Associated Lung Injury Case Report

“…Although there have been some rare case studies showing a similar pattern of vaping induced pneumomediastinum, CT of chest in this case showed extensive pneumomediastinum as well as pneumopericardium. 7,8,9,10 This image highlights many findings that can be seen in EVALI, including ground glass opacities with subpleural sparing as well as pneumomediastinum and pneumopericardium.…”

A Case Report of Secondary Spontaneous Pneumomediastinum Induced by Vaping

“…There have also been reported cases of spontaneous pneumomediastinum in young patients caused by inhalation of marijuana [ 2 , 5 ] and crack cocaine [ 6 , 7 ]. Vaping-induced pneumomediastinum is a less commonly reported phenomenon, with only four other cases reported in the literature [ 3 , 8 - 10 ]. Each reported case presented similarly to ours in an otherwise young, healthy patient with no known past medical history.…”

Pneumomediastinum and Pneumorrhachis Associated With Cannabinoid Hyperemesis Syndrome

“…The mechanism of PM seems likely to be a micro-tear in the esophagus that thus far has not been reported to cause Boerhaave syndrome which requires anything beyond observation. Another theory proposed to explain the association of spontaneous PM, and hyperemesis syndrome, includes the increase in thoracic pressure caused by Valsalva maneuvers during vomiting which in turn predisposes an individual to barotrauma that can rupture bullae/blebs [ 8 ]. This association of MJ smoking leading to bullae ruptures potentially causing PM and pneumothorax is more likely to be seen with concomitant tobacco smoking [ 9 , 10 ].…”