Pneumomediastinum following Ecstasy (methylenedioxymetamphetamine, MDMA) ingestion in two people at the same ’rave’

Abstract

Ecstasy is a class A controlled drug often consumed by the young population for recreational purposes. Documented complications of its use include hyperpyrexia, disseminated intravascular coagulation (DIC), renal failure and rhabdomyolysis. We report on two patients who developed pneumomediastinum after Ecstasy abuse. Both patients obtained and consumed the drug at the same establishment and presented to the same hospital within half an hour. The possible pathogenesis of this complication are discussed and the literature reviewed. Pneumomediastinum should be recognized as a possible complication of Ecstasy use. Conservative management is appropriate.

Ecstasy-Associated Pneumomediastinum

“…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.…”

“…One patient had a small tear demonstrated and was treated conservatively. 10 All remaining patients were also treated conservatively without any reported sequelae. Table 2 Reported cases of ecstasy-associated pneumomediastinum…”

“…Given the illicit nature of this drug, the purity of the drug is known to differ widely. In the case report by Rejali et al,10 where two patients from the same rave party both presented with spontaneous pneumomediastinum, it is conceivable that the MDMA came from the same source and, therefore, contained the same contaminants. However, this hypothesis does not explain the numerous other case reports in the literature.…”

Neumomediastino y enfisema cervical tras consumo de "éxtasis" (3,4 metilendioximetanfetamina)

“…El éxtasis (3,4 metilendioximetanfetamina, MDMA) es una droga ilegal de la clase A, de las denominadas de diseño y diversión, cuyo consumo ha aumentado en los países occidentales entre los jóvenes y adolescentes en los últimos años (1). Es un derivado de la metanfetamina que produce múltiples complicaciones asociadas con su consumo (1).…”

“…Es un derivado de la metanfetamina que produce múltiples complicaciones asociadas con su consumo (1). Las más graves están relacionadas con un aumento exagerado de la actividad simpático-mimética e incluyen agitación, hiperpirexia, coagulación intravascular diseminada, rabdomiolisis y fallo renal (2).…”