Marijuana induced spontaneous pneumomediastinum

Abstract

Spontaneous pneumomediastinum (SPM), a rare occurrence, is defined by the presence of extraluminal gas in the mediastinum in the absence of trauma or underlying parenchymal disease. It is usually benign and has been associated with the inhalation of marijuana, cocaine, and amphetamines. The breathing maneuvers along with cyclical vomiting have been postulated as the underlying etiology. We present a case of a 27-year-old previously healthy male who presented with sudden onset chest pain and was found to have marijuana-induced pneumomediastinum.

A Case Report of Secondary Spontaneous Pneumomediastinum Induced by Vaping

“…The inhalation of illicit substances, especially when done repeatedly and forcefully, leads to a sudden increase in intra-alveolar pressure resulting in barotrauma that causes alveolar rupture. Alveolar rupture causes air to dissect into the peribronchial and perivascular space and ultimately into the mediastinum [1][2][3]. By a similar mechanism, alveolar rupture secondary to vaping can also cause pneumothorax.…”

“…There have been several cases of vaping associated spontaneous pneumothorax (VASP) reported in the literature [4]. 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][9][10].…”

“…In the majority of cases, spontaneous pneumomediastinum is a self-limiting condition requiring only supportive care with proper pain control, antitussives, and imaging studies to confirm resolution. Patients are typically hemodynamically stable and can be admitted for short inpatient observation [2,3,5,[7][8][9][10]. The diagnosis of spontaneous pneumomediastinum is largely one of exclusion and is confirmed with imaging.…”

Spontaneous Pneumomediastinum in Marijuana Users

“…Spontaneous pneumomediastinum is a rare condition that can occur due to the inhalation route for recreational drug usage [ 4 ]. In 2019, a retrospective review of 14 cases of non-traumatic pneumomediastinum was conducted, and 66.7% were associated with marijuana use.…”

March 2023 Medical Image of the Month: Spontaneous Pneumomediastinum as a Complication of Marijuana Smoking Due to Müller's Maneuvers

“…This can result in the escape of air into the mediastinum, leading to the development of pneumomediastinum. SPM has been associated with the inhalation of drugs such as cocaine, amphetamines, and marijuana (1)(2)(3)(4). Attempted inspiration through a closed glottis or Muller's maneuver results in a drop in intrathoracic pressure, which increases alveolar air volume, causing alveolar distension and rupture which can cause shear damage and air leakage along a bronchovascular bundle into the mediastinum.…”