Spontaneous Cervical and Mediastinal Air Emphysema After Ecstasy Abuse

作者：Rachid Badaoui, C. El Kettani, Muhammad Fikri, Martial Ouendo, P. Canova-Bartoli, Michel Ossart · 发表于：Anesthesia & Analgesia · 年份：2002 · DOI：10.1213/00000539-200210000-00071 · 被引用次数：15 · 研究领域：Pneumothorax, Barotrauma, Emphysema、Restraint-Related Deaths、Trauma Management and Diagnosis

To the Editor: Pneumothorax and spontaneous pneumomediastinum should be considered in an Ecstasy user who complains of chest pain, neck pain, or shortness of breath (1–5). We report a case of a patient who presented with subcutaneous cervical air emphysema and spontaneous pneumomediastinum associated with Ecstasy use. A 27-year-old man was admitted to the hospital, complaining of sudden chest pain and dyspnea. He had taken one tablet of Ecstasy and was an occasional drug abuser. No history of trauma or surgery was reported. Initial examination showed cervicofacial and thoracic subcutaneous air emphysema. The initial chest radiograph showed emphysema in the cervicofacial, thoracic, and axillary regions with no evidence of rib fracture or pneumothorax. The results of the esophagogram, otolaryngologic examination, and bronchoscopy ruled out any abnormality. The chest CT demonstrated air in the subcutaneous, visceral, and carotid spaces of the neck, extending along the anterior mediastinal space. A small left pneumothorax was also observed. During the following days, the patient’s condition improved notably, with almost total resolution of the cervical emphysema and pneumomediastinum shown in the radiographs. Ecstasy, a dangerous psychoactive drug, has become a popular recreational drug on college campuses and dance halls in the world. Some cardiac arrhythmias requiring medical attention have been associated with consumption of Ecstasy and some fatalities. This is a case of spont...