Recurrent subcutaneous emphysema as a consequence of bulimia nervosa

Abstract

It is believed that increased intrathoracic pressure and nutritional deficiency associated with repeated induced vomiting contributed to this complication. This is the only case of recurrent subcutaneous emphysema. While in this case, and in most cases, the course was benign with eventual reabsorption of the subcutaneous air, pneumomediastinum can be a life-threatening complication of bulimia nervosa.

Extensive Surgical Emphysema Due to Fishbone Ingestion: A Rare Case Report

“…It results from self-purging behaviour; therefore, patients are kept under close observation and covered with broad-spectrum antibiotics to avoid future complications. 3,8,9 In our case, the surgical emphysema was extensive and progressive; thus, surgical intervention was necessary.…”

Medical complications of bulimia nervosa

“…Retching during vomiting increases intrathoracic and intra-alveolar pressures, which can lead to pneumomediastinum. 22 Pneumomediastinum may also be encountered due to nontraumatic alveolar rupture in the setting of malnutrition and is therefore nonspecifi c in differentiating patients who purge from those who restrict. 23 Vomiting also increases the risk of aspiration pneumonia.…”