Description

ABSTRACT

Introduction: Spontaneous pneumomediastinum is a rare entity. It can occur subsequent to forceful inhalation of recreational drug like cannabis. Case Report: A 21 years old Caucasian male patient from Europe presented to our Emergency Ward with acute onset of chest heaviness and uneasiness during respiration. He admitted to have smoked cannabis with forceful inhalation an hour before the initiation of symptoms. He denied any history of trauma. Physical examination demonstrated palpable crepitation over the anterior chest wall and bilateral axillary region. Chest X-ray and subsequent CECT-Chest revealed pneumomediastinum with subcutaneous emphysema without pneumothorax. He was managed conservatively with high flow oxygen and analgesics. After 60 hours of observation in medical ward, he was discharged from the hospital. Conclusion: Spontaneous pneumomediastinum is a rare but benign entity, which can occur after forceful inhalation of cannabis. It is associated with subcutaneous emphysema and can be diagnosed with chest X-ray. CT Scan chest is required to rule out other causes. Management is mostly conservative with oxygen supplementation, pain control and observation for any complications.

 Keywords: Cannabis, Inhalation, Spontaneous, Pneumomediastinum, Pneumothorax