RT Journal Article
SR Electronic
T1 Pneumomediastinum as a complication of cocaine abuse
JF Clinical Medicine
JO Clin Med
FD Royal College of Physicians
SP 321
OP 324
DO 10.7861/clinmedicine.19-4-321
VO 19
IS 4
A1 Catriona Macrae
A1 Christopher Brown
A1 Christine Aiken
A1 Ravi Jamdar
YR 2019
UL http://www.rcpjournals.org/content/19/4/321.abstract
AB A 26-year-old male presented with a 24-hour history of pleuritic chest pain following intranasal cocaine insufflation. He was a smoker, cannabis and alcohol user. Cardiovascular and respiratory examinations were unremarkable.His admission blood tests were within normal limits. The admission electrocardiogram (ECG) showed sinus rhythm, with ST-segment elevation in an inferolateral distribution. This appeared to be an early repolarisation abnormality, with no evolving changes.His chest radiogram showed a double outline at the left heart border with subcutaneous gas collection over the left supraclavicular fossa but no evidence of pneumothorax. A computed tomography (CT) showed prominent mediastinum with gas tracking into the neck but no connection to the oesophagus or pneumothorax.He was managed conservatively and a repeat chest radiogram after 48 hours showed improvement.