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      A Rare Case of Vaping-Induced Spontaneous Pneumomediastinum

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          Abstract

          Vaping is the process of inhaling an aerosol produced by heating a liquid or wax containing substances such as nicotine, cannabinoids (e.g., tetrahydrocannabinol, cannabidiol), flavoring, and additives (e.g., glycerol, propylene glycol). The presence of air or gas in the mediastinum is pneumomediastinum.

          We present a rare case of vaping-induced spontaneous pneumomediastinum. A young 20-year-old female patient with a history of vaping and no past medical history presented with acute chest pain to an emergency room. The urine drug screen was positive for cannabinoids. Imaging studies - chest x-ray and computed tomography of the chest - showed pneumomediastinum. The patient was discharged after a day of observation and counseling to quit vaping.

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          Pulmonary Illness Related to E-Cigarette Use in Illinois and Wisconsin — Preliminary Report

          Jennifer E. Layden, Isaac Ghinai, Ian W. Pray … (2019)
          New England Journal of Medicine
          Article 0 comments Cited 301 times – based on 0 reviews     Review now
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            What are the respiratory effects of e-cigarettes?

            Jeffrey Gotts, Sven-Eric Jordt, Rob McConnell … (2019)
            ABSTRACT Electronic cigarettes (e-cigarettes) are alternative, non-combustible tobacco products that generate an inhalable aerosol containing nicotine, flavors, propylene glycol, and vegetable glycerin. Vaping is now a multibillion dollar industry that appeals to current smokers, former smokers, and young people who have never smoked. E-cigarettes reached the market without either extensive preclinical toxicology testing or long term safety trials that would be required of conventional therapeutics or medical devices. Their effectiveness as a smoking cessation intervention, their impact at a population level, and whether they are less harmful than combustible tobacco products are highly controversial. Here, we review the evidence on the effects of e-cigarettes on respiratory health. Studies show measurable adverse biologic effects on organ and cellular health in humans, in animals, and in vitro. The effects of e-cigarettes have similarities to and important differences from those of cigarettes. Decades of chronic smoking are needed for development of lung diseases such as lung cancer or chronic obstructive pulmonary disease, so the population effects of e-cigarette use may not be apparent until the middle of this century. We conclude that current knowledge of these effects is insufficient to determine whether the respiratory health effects of e-cigarette are less than those of combustible tobacco products.
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              Spontaneous Pneumomediastinum: Time for Consensus

              Sonu Sahni, Sameer Verma, Jinette Grullon … (2013)
              Pneumomediastinum (PM) is defined as the presence of free air in the mediastinal cavity. It is often regarded as a revealing sign of a more serious medical condition. PM is broken down into two categories, one, with an instigating event, referred to as secondary PM. The other is when free air is discovered in the mediastinal cavity without a clear etiology, referred to as spontaneous pneumomediastinum (SPM). Often misdiagnosed due to the vague nature of presenting symptoms, SPM must be part of the differential diagnosis of a chest pain patient to expedite discovery and if necessary, management. A MedLine/PubMED search was performed identifying all relevant articles with “SPM” in the title. Six case series were reviewed to determine what clinical scenario constitutes a possible case of SPM. Results showed that almost all patients with SPM exhibited some chest pain, but Hamman’s crunch was present in only one-fifth of patients. Patients with certain pre-existing pulmonary diseases showed a greater propensity for the presence of free air in the mediastinal cavity. SPM must be diagnosed and managed promptly due to rare, but serious complications and any chest pain with an unknown etiology should contain SPM in the differential diagnosis.
              Article 0 comments Cited 70 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Journal ID (nlm-ta): Cureus
                Journal ID (iso-abbrev): Cureus
                Journal ID (issn): 2168-8184
                Title: Cureus
                Publisher: Cureus (Palo Alto (CA) )
                ISSN (Electronic): 2168-8184
                Publication date (Electronic, pub): 13 August 2021
                Publication date (Electronic, collection): August 2021
                Volume: 13
                Issue: 8
                Electronic Location Identifier: e17166
                Affiliations
                [1 ] Hospital Medicine, Franciscan Health, Lafayette, USA
                [2 ] Geriatrics, Brown University, Providence, USA
                [3 ] Internal Medicine, Temple University Hospital, Philadelphia, USA
                [4 ] Critical Care, Mayo Clinic, Rochester, USA
                [5 ] Critical Care Medicine, Mayo Clinic, Mankato, USA
                [6 ] Pediatrics/Translational Research, Thomas Jefferson University, Philadelphia, USA
                [7 ] Internal Medicine, Mayo Clinic Health System, Mankato, USA
                Author notes
                Article
                DOI: 10.7759/cureus.17166
                PMC ID: 8435398
                PubMed ID: 34532191
                SO-VID: a11d7561-fd96-40ae-850f-0e874f13db2d
                Copyright © Copyright © 2021, Adhikari et al.
                License:

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                Date accepted : 13 August 2021
                Categories
                Subject: Internal Medicine
                Subject: Pulmonology
                Subject: Public Health

                Keywords: pneumomediastinum,effects of vaping,e-cigarette or vaping use-associated lung injury (evali),spontaneous pneumomediastinum,e-cigarette smoking,cannabinoids,electronic nicotine delivery systems (ends),electronic nicotine delivery systems,flavors,e-smoking
                Data availability:
                Keywords: pneumomediastinum, effects of vaping, e-cigarette or vaping use-associated lung injury (evali), spontaneous pneumomediastinum, e-cigarette smoking, cannabinoids, electronic nicotine delivery systems (ends), electronic nicotine delivery systems, flavors, e-smoking

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