UMEM Educational Pearls

Title: What's the Diagnosis? Case By Dr. Semhar Tewelde

Category: Visual Diagnosis

Posted: 6/1/2015 by Haney Mallemat, MD
Click here to contact Haney Mallemat, MD

Patient presents with chest pain after smoking crack cocaine; what's the diagnosis?

Pneumomediastinum secondary to crack cocaine inhalation

Causes of Pneumomediastinum

Tracheal or bronchial perforation (e.g., trauma s/p bronchoscopy)
Mediastinitis (e.g., rapidly descending dental infections)
Esophageal perforation (e.g., Boerhaave syndrome or post-endoscopy)
Mediastinal trauma (e.g., stab wound to chest)
Rupture of lung parenchyma
- Ruptured bleb (e.g., COPD exacerbation)
- Valsalva maneuver (e.g., smoking illicit substances or childbirth)
- Barotrauma (e.g., mechanical ventilation or severe asthma exacerbation)
- Scuba Diving

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