1/9. Spontaneous pneumomediastinum and myocarditis following Ecstasy use: a case report.Ecstasy is a very popular and widely used party drug with known complications such as agitation, hyperpyrexia, rhabdomyolysis or renal failure. A 16-year-old boy was admitted to our Emergency Department with a spontaneous pneumomediastinum (SPM) after Ecstasy ingestion, complicated by myocarditis. To our knowledge this is the first case described with the combination of Ecstasy ingestion, SPM and myocarditis. Although SPM is well known in inhalation drug users who try to enhance alveolar resorption with repeated valsalva manoeuvres, it is rather rare after the ingestion of party drugs. The probable causative event is the prolonged and excessive dancing in this party drug culture. The course is usually benign, with spontaneous resorption. Emergency physicians should be aware of the risk, especially if a drug user presents with neck emphysema, difficulty in swallowing, and precordial crepitations or thoracic pain. Ecstasy, similarly to cocaine, can induce cardiac symptoms.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
2/9. Pneumomediastinum as initial presentation of paralytic rabies: a case report.BACKGROUND: rabies is readily diagnosed when it presents as the classic furious form. Paralytic and atypical forms can pose significant problems in diagnosis. Catastrophic incidents included 7 organ transplant recipients who died of rabies recently in united states and germany. Although rabies remains top in the lists of differential diagnosis of encephalitis in rabies endemic area, its complication may divert physicians from making a relevant management. We encountered an unusual case of paralytic rabies who presented with spontaneous pneumomediastinum. CASE PRESENTATION: A young male presented with fever and dysphagia. There was a history of fluctuating consciousness and aerophobia but they were absent or could not be demonstrated at the time of admission. He exhibited subcutaneous chest wall emphysema and was found to have pneumomediastinum which resulted in surgical intervention. He developed paralysis followed by seizures during postoperative period. diagnosis was confirmed by demonstration of rabies rna in saliva during the preterminal phase and by the autopsy. Over 200 hospital staff subsequently received rabies postexposure prophylaxis. CONCLUSION: Spontaneous pneumomediastinum can be a rare complication of rabies. It may lead clinicians to perform inappropriate treatment, particularly when phobic spasms are not present and agitation is not prominent. High level of awareness of rabies in any patient with confusion albeit subtle or with any obscure neurological presentations such as difficulty swallowing with no identifiable causes must be borne in mind.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
3/9. subcutaneous emphysema and pneumomediastinum secondary to dental extraction: a case report and literature review.Here, we present the case of a woman who suffered from acute dyspnea and right cheek and neck swelling during molar extraction. The use of a high-speed dental drill may introduce air into the soft tissue and lead to subcutaneous emphysema and pneumomediastinum. After a review of the literature, we found that subcutaneous emphysema and pneumomediastinum are rare complications secondary to dental extraction. We report this case because physicians in the emergency department may misdiagnose the symptoms as an allergic reaction. dentists should be more aware of air leak during dental extraction.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
4/9. Spontaneous pneumomediastinum. An unusual cause of a sore throat.Sore throat, usually related to pharyngitis, is a common presenting symptom in the primary care setting. Drs Frenkel and Lyons describe a case showing that physicians need to be aware of another, puzzling cause--spontaneous pneumo-mediastinum.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
5/9. Traumatic rupture of the stomach after heimlich maneuver.Fatal complications following the performance of the heimlich maneuver have been reported. A 76-year-old woman presented to the emergency department with signs of respiratory distress, abdominal pain and distension one day after airway obstruction and subsequent resuscitation. Despite successful immediate laparotomy and repair of a ruptured stomach, she later succumbed to the sequelae of aspiration of gastric contents and dehiscence of the gastric tear. This is the 4th case of stomach rupture and the 7th reported fatal complication following the heimlich maneuver. It is recommended that persons who undergo the heimlich maneuver be examined and observed by a physician, as soon as possible, to rule out complications.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
6/9. Pneumomediastinum after cocaine smoking.We have reported two cases of pneumomediastinum occurring in previously healthy young men after smoking cocaine and performing the valsalva maneuver to intensify the euphoria. Pneumomediastinum is thought to result from increased intrathoracic pressure produced by the valsalva maneuver, with resultant rupture of marginal alveoli. With the increasing popularity of inhaling free-base cocaine, physicians should be aware of this complication.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
7/9. Spontaneous pneumothorax in weightlifters.Spontaneous pneumothorax is infrequently caused by strenuous exertion. To our knowledge there has only been one case of spontaneous pneumothorax associated with weightlifting reported in the medical literature. We describe three consecutive cases of spontaneous pneumothorax associated with weightlifting. We postulate that spontaneous pneumothorax in these patients may be secondary to improper breathing techniques. It is important that physicians and weight trainers be aware of the association between weight lifting and spontaneous pneumothorax and assure that proper instruction is given to athletes who work with weights.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
8/9. Spontaneous cervical subcutaneous and mediastinal emphysema secondary to occult sigmoid diverticulitis.We present a case of spontaneous mediastinal and subcutaneous cervical emphysema due to perforation of an occult sigmoid diverticulitis. mediastinal emphysema should alert the physician to the possibility of retroperitoneal gastrointestinal perforation, even in patients without signs of distinct peritoneal irritation.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
9/9. Spontaneous pneumothoraces, pneumomediastinum, and pneumoperitoneum: consequences of smoking crack cocaine.The combination of pneumothoraces, pneumomediastinum, and pneumoperitoneum is a rare consequence of smoking crack cocaine. This is a report of this trilogy of findings in a 17-year-old girl who attempted suicide by smoking crack cocaine. This case is important to the emergency physician because the increase in crack cocaine use among the adolescent population.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |