Spontaneous pneumomediastinum, pneumothorax and ecstasy abuse

Mazur, Stefan M; Hitchcock, Thomas

doi:10.1046/j.1442-2026.2001.00190.x

Cited by 33 publications

(20 citation statements)

References 17 publications

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“…Thirteen previous reports outlining case histories of 15 patients were identified in the world literature dating from 1993 ( Table 2). [1][2][3][4][5][6][7][8][9][10][11][12][13] Eight of the 15 patients underwent gastrograffin swallow to exclude oesophageal dysfunction. One patient had a small tear demonstrated and was treated conservatively.…”

Section: Resultsmentioning

confidence: 99%

Ecstasy-Associated Pneumomediastinum

Marasco

Lim

2007

annals

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INTRODUCTION Ecstasy, also known as MDMA (3,4, methylenedioxymethamphetamine), is a popular illicit party drug amongst young adults. The drug induces a state of euphoria secondary to its stimulant activity in the central nervous system. PATIENTS AND METHODS A database review at two major inner city hospitals was undertaken to identify patients presenting with pneumomediastinum and their charts reviewed. A Medline review of all reported cases of pneumomediastinum associated with ecstasy abuse was undertaken. RESULTS A total of 56 patients presenting with pneumomediastinum were identified over a 5-year period. Review of the charts revealed a history of ecstasy use in the hours prior to presentation in six of these patients, representing the largest series reported to date.CONCLUSIONS Review of previously reported cases reveals the likely mechanism is due to Valsalva manoeuvre during periods of extreme physical exertion, and not a direct pharmacological effect of the drug. KEYWORDSMediastinal emphysema -N-Methyl-3,4-methylenedioxyamphetamine -Ecstasy

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Section: Resultsmentioning

confidence: 99%

Ecstasy-Associated Pneumomediastinum

Marasco

Lim

2007

annals

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“…It has been suggested that spontaneous pneumomediastinum arises from perivascular alveolar rupture and subsequent escape of air through the vascular sheaths into the mediastinum, and thereafter to the fascial planes of the neck, as the air follows the path of least resistance [2]. Perivascular alveolar rupture can be caused by sudden increases in the bronchovascular pressure gradient, through an increase in alveolar pressure such as in mechanical ventilation and Valsalva manoeuvre, or a decrease in pulmonary interstitial pressure such as in asthma and bronchiolitis [3]. …”

Section: Discussionmentioning

confidence: 99%

“…All 22 previous cases of ecstasy-related pneumomediastinum reported in the literature presented with either chest pain and/or breathlessness [3, 5–16]. The chest pain is usually pleuritic in nature and has been reported to radiate to the neck [8] or back [8, 10].…”

Section: Discussionmentioning

confidence: 99%

“…The chest pain is usually pleuritic in nature and has been reported to radiate to the neck [8] or back [8, 10]. Neck swelling corresponding to underlying subcutaneous emphysema is also common [3, 5, 8, 13, 15, 16]. Dysphagia [6, 10], sore throat/odynophagia [3, 5, 9, 16, 17], and dysphonia [7] have also been documented.…”

Section: Discussionmentioning

confidence: 99%

“…Examination shows only subcutaneous emphysema in many patients [3, 5, 6, 8, 13, 16]. Tachycardia and Hamman's sign can also be present [5, 7, 9, 11, 15, 17, 18].…”

Section: Discussionmentioning

confidence: 99%

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Extensive Subcutaneous Emphysema and Pneumomediastinum after Ecstasy Ingestion

Gungadeen

Moor

2013

Case Reports in Otolaryngology

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Objective. To present a rare case of extensive subcutaneous emphysema and spontaneous pneumomediastinum following ingestion of Ecstasy in a young adult. We also review the relevant literature and discuss how this case supplements it. Case Report. We report a case of a 19-year-old man with a history of painless neck and chest swelling, and no chest pain or breathlessness, after consuming Ecstasy tablets. Radiological imaging showed evidence of pneumomediastinum and extensive subcutaneous emphysema. The patient remained well under observation and his symptoms improved with conservative management. Conclusions. Subcutaneous emphysema and pneumomediastinum after Ecstasy ingestion is uncommon. Cases are often referred to the otolaryngologist as they can present with neck and throat symptoms. Our case showed that the severity of symptoms may not correlate with severity of the anatomical abnormality and that pneumomediastinum should be suspected in Ecstasy users who present with neck swelling despite the absence of chest symptoms. Although all cases reported so far resolved with conservative management, it is important to perform simple investigations to exclude coexisting serious pathology.

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Methylenedioxymethamphetamine (Ecstasy, MDMA)

Buckley

2012

Medical Toxicology of Drug Abuse

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Spontaneous pneumomediastinum, pneumothorax and ecstasy abuse

Abstract: A case report is presented of a patient with bilateral pneumothoraces and spontaneous pneumomediastinum associated with ecstasy use. Pneumothorax and spontaneous pneumomediastinum should be considered in an ecstasy user who complains of chest pain, neck pain or shortness of breath.

Cited by 33 publications

References 17 publications

Ecstasy-Associated Pneumomediastinum

Ecstasy-Associated Pneumomediastinum

Extensive Subcutaneous Emphysema and Pneumomediastinum after Ecstasy Ingestion

Methylenedioxymethamphetamine (Ecstasy, MDMA)

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