Pneumomediastinum, neobvyklý nález na ORL ambulanci

The article describes a case of spontaneous pneumomediastinum associated with illicit drug abuse. A young man in mild inebriation visited an ENT clinic in early morning hours complaining of sore throat and chest pain. After examination he was diagnosed with acute pharyngitis and discharged. He returned after several hours due to aggravation of symptoms and a tender swelling of the neck. On examination a crepitating emphysema was found and the patient was admitted for further evaluation. A CT examination was performed showing soft tissue emphysema of the neck and pneumomediastinum. Searching for the cause of this condition a toxicology screening was ordered with positive results for MDMA (ecstasy). Further management was conservative with signs of regression on a follow-up CT and the patient was then discharged.