TY - JOUR T1 - Pneumomediastinum as a complication of cocaine abuse JF - Clinical Medicine JO - Clin Med SP - 321 LP - 324 DO - 10.7861/clinmedicine.19-4-321 VL - 19 IS - 4 AU - Catriona Macrae AU - Christopher Brown AU - Christine Aiken AU - Ravi Jamdar Y1 - 2019/07/01 UR - http://www.rcpjournals.org/content/19/4/321.abstract N2 - 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. ER -