Pneumomediastinum and pneumoretroperitoneum as a result of mephedrone intoxication – a case report.

Abstract

IntroductIon: Presence of air in mediastinal space, retroperitoneal space or subcutaneously is a rare condition in majority caused by trauma of airway or gastrointestinal (GI) tract. Rarely can it occur as a consequence after drug usage. cAse presentAtIon: We report a non-traumatic occurrence of pneumomediastinum, pneumoretroperitoneum and subcutaneous emphysema in a 27 year-old male patient who had been inhaling mephedrone for 4 days. Patient was admitted to Department of General, Endocrine and Transplant Surgery, Medical University of Gdansk. CT scans of neck, chest and abdomen were performed with suspicion of perforation of GI tract or airways. Perforation was excluded by gastroscopic and bronchoscopic examinations. Patient was treated conservatively with fluids and antibiotic therapy because of no abnormalities besides free air in mentioned cavities. During 6 days of hospitalization patient made a steady recovery and was discharged in good condition. conclusIons: The presence of pneumomediastinum, pneumoretroperitoneum and subcutaneous emphysema associated with mephedrone inhalation has been rarely reported in the literature in the past. There are only a few cases describing such complications and medical management required. By reporting this case we would like to emphasize that mentioned symptoms and history of drug use might seem life-threatening, however, this condition may be self-limiting as well. Therefore, good general state can potentially be indication for a watch-and-wait approach with no surgical intervention necessary.