The Special K Constellation, a Rare Presentation of Ketamine Use: A Case Report

Abstract

Ketamine is commonly used in the emergency medicine setting, but also as a recreational drug. There have been many animal studies investigating ketamine, but little data on long-term clinical use of ketamine in humans. In this case presentation, a 22-year-old international male student presented with crepitus and cachexia and was found to have extensive subcutaneous emphysema, pneumorrhachis/intraspinal air, pneumomediastinum, and multiorgan failure. In this case report, we discuss how ketamine abuse is the likely cause of these findings.

Triad of obstructive uropathy, cholestasis, and pneumomediastinum associated with chronic ketamine abuse: a case report

“…Pneumomediastinum has been infrequently appeared after ketamine snorting and may result from sudden increase in intra-alveolar pressure following a Valsalva's maneuver during insufflation of ketamine [8]. Two other case reports illustrate this triad of pneumomediastinum, elevated alkaline phosphatase and hydronephrosis in young ketamine abusers [9][10].…”

Radiological Manifestations of Ketamine Abuse

“…Ketamine abuse commonly leads to urinary tract destruction "The Ketamine bladder syndrome," which is thought to be caused by the smooth muscle relaxing property of ketamine. Chronic Ketamine abuse damages the urinary bladder, causing ulcers, cystitis, and fibrosis, resulting in urinary incontinence, hematuria, bladder overactivity, and shrinkage, and in the later stage, uretero-hydronephrosis [1]. It also may cause epigastric pain, gastritis, and biliary system abnormalities, that is, irregularity and non-obstructive biliary dilatation associated with impairment of the liver function.…”