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- Rahul V Nene, Adam T Hryniewicki, Elizabeth Roderick, Scott Chicotka, Moises Hernandez Vazquez, Patricia A Thistlewaite, Christanne Coffey, and Mazen F Odish.
- Department of Emergency Medicine, University of California San Diego, San Diego, CA, USA. Electronic address: rnene@ucsd.edu.
- Am J Emerg Med. 2022 Mar 1; 53: 281.e5-281.e8.
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.Published by Elsevier Inc.
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