Pneumomédiastin et consommation de cocaïne

Underner, M.; Perriot, Jean; Peiffer, G.

doi:10.1016/j.jeurea.2017.08.006

Cited by 1 publication

(1 citation statement)

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“…Consequently, this leads to extravasation of air to the mediastinum, which is known as the "Macklin effect". 13,14 Air may then travel upwards through the neural foramina, into the epidural space resulting in free intraspinal air, known as a pneumorrhachis. 12 Factors that can predispose an individual to the development of a spontaneous pneumomediastinum are comorbidities such as asthma and interstitial lung disease.…”

Section: Discussionmentioning

confidence: 99%

Pneumomediastinum, subcutaneous emphysema and pneumorrhachis following cocaine insufflation: a case report

2020

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A case report on a 36-year-old male patient presenting to the emergency department (ED) with chest tightness, nasal sounding voice and subcutaneous emphysema 72 hours after the nasal insufflation of approximately 0.5g of cocaine. A plain radiograph of the chest demonstrated an extensive pneumomediastinum with subcutaneous emphysema extending into his neck. A computerised tomography (CT) scan confirmed the above findings, along with a pneumorrhachis of the thoracic spine. He was admitted locally for further investigation and observation. Cocaine is the second most used illicit drug in the UK. The associated complications of cocaine can vary from acute coronary syndrome to acute psychosis. Pulmonological trauma secondary to cocaine misuse is commonly associated with inhalation of cocaine; we present this rare case of subcutaneous emphysema, pneumomediastinum and pneumorrhachis secondary to nasal insufflation. It is believed that deep nasal insufflation of cocaine is followed by forceful Valsalva manoeuvre, which allows for the rapid absorption of the drug and increases the euphoric effect. This forceful inhalation can lead to barotrauma and leakage of air into the posterior mediastinum.

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Section: Discussionmentioning

confidence: 99%