Case report: Tension pneumomediastinum from opioid inhalation

AbstractPneumomediastinum is a rare complication of substance use, likely due to a Valsalva maneuver after drug inhalation. There are no previously documented associations between pneumomediastinum and opioid use. A 30-year-old man with a history of recent heroin and fentanyl inhalation presented to...

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Bibliographic Details
Published in:The American journal of emergency medicine 2021-09, Vol.53, p.281.e5-281.e8
Main Authors: Nene, Rahul V., MD PhD, Hryniewicki, Adam T., MD, Roderick, Elizabeth, MD, Chicotka, Scott, MD, Vazquez, Moises Hernandez, MD, Thistlewaite, Patricia A., MD, PhD, Coffey, Christanne, MD, Odish, Mazen F., MD
Format: Article
Language:English
Subjects:
Emergency
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Summary:AbstractPneumomediastinum is a rare complication of substance use, likely due to a Valsalva maneuver after drug inhalation. There are no previously documented associations between pneumomediastinum and opioid use. A 30-year-old man with a history of recent heroin and fentanyl inhalation presented to the emergency department in respiratory distress requiring intubation. His course was complicated by pneumomediastinum which subsequently developed tension physiology. He required emergent surgical decompression with a “blowhole incision” to his anterior chest. Although a rare complication of polysubstance use, pneumomediastinum can progress to tension physiology, requiring prompt diagnosis and management.
ISSN:0735-6757
1532-8171
DOI:10.1016/j.ajem.2021.09.008