Pneumomediastinum as a complication of MDMA (3,4-methylenedioxymetamfetamine, Ecstasy) ingestion

Pneumomediastinum as a complication of MDMA (3,4-methylenedioxymetamfetamine, Ecstasy) ingestion

Abstract

MDMA (3,4-methylenedioxymethamfetamine, Ecstasy) is a widely used recreational drug. We present a case of pneumomediastinum as a complication of MDMA use in a 21-year-old man with no previous history of lung or gastrointestinal pathology. We have performed a literature review, and summarised the symptoms, signs, and prognosis for this under-recognised complication of a commonly used recreational drug. We recommend enquiring about illicit drug use in any patient presenting with spontaneous pneumomediastinum.

[download-attachments container="div" style="list" display_icon="1" display_count="1" display__size="0"]

References

  1. Ahmed J.M et al., (1998). Chest pain in a young girl, Postgraduate Medical Journal. 74 (868) (pp 115-116).
  2. Badaoui R et al., (2002). Spontaneous cervical and mediastinal air emphysema after ecstasy abuse [7], Anesthesia and Analgesia. 95 (4) (pp 1123).
  3. Brière F.N et al., (2012). Child and adolescent health: Prospective associations between meth/amphetamine (speed) and MDMA (ecstasy) use and depressive symptoms in secondary school students, J Epidemiol Community Health. 66:11; 990-994.
  4. Burghart S and Armbruster C, (2005). Ecstasy induced pneumomediastinum and pneumothorax-new causes, new questions, Respiratory Medicine Extra. 1 (3) (pp 53-55).
  5. Clause A.L et al., (2014). Spontaneous pneumomediastinum and epidural pneumatosis after oral ecstasy consumption, Acta Clinica Belgica. 69 (2) (pp 146-148).
  6. Gungadeen A and Moor J, (2013). Extensive Subcutaneous Emphysema and Pneumomediastinum after Ecstasy Ingestion, Case Reports in Otolaryngology Volume 2013, Article ID 795867, 3 pages.
  7. Hall A.P and Henry J.A, (2006). Acute toxic effects of ‘Ecstasy’ (MDMA) and related compounds: overview of pathophysiology and clinical management, British Journal of Anaesthesia. 96 (6):678–85.
  8. Hoffman R.J et al., (2014). MDMA (ecstasy) intoxication UpToDate [online], accessed 24/10/2015 via http://www.uptodate.com/contents/mdma-ecstasy-intoxication?source=machineLearning&search=ecstasy+overdose&selectedTitle=1%7E5&sectionRank=1&anchor=H4#H4
  9. Janjua F.R et al., (2014). Pneumomediastinum after riding a roller coaster. American Journal of Respiratory and Critical Care Medicine. Conference: American Thoracic Society International Conference, ATS 2014 San Diego, CA United States. Conference Start: 20140516 Conference End: 20140521. Conference Publication: (var.pagings). 189.
  10. Jones N.L, Evans R.J. (1996). FROM MINERVA’S PHOTO ALBUM, BMJ [online], accessed 15/11/2015 via http://europepmc.org/backend/ptpmcrender.fcgi?accid=PMC2359139&blobtype=pdf
  11. Takada K et al., (2008). Management of spontaneous pneumomediastinum based on clinical experience of 25 cases. Respir Med. 2008 Sep;102(9):1329-34. doi: 10.1016/j.rmed.2008.03.023.
  12. Le Floch.A.S et al., (2002). Pneumomediastinum as a complication of an ecstasy recreational use. Annales Francaises d’Anesthesie et de Reanimation. 21 (1) (pp 35-37).
  13. Levine A.J et al., (1993). ‘Ecstasy’ induced pneumomediastinum. J R Soc Med. 86(4): (pp232–233).
  14. Macia I et al., (2007). Spontaneous pneumomediastinum: 41 cases. Eur J Cardiothorac Surg. 2007 Jun;31(6):1110-4.
  15. Marasco S.F and Lim H.K. (2007). Ecstasy-associated pneumomediastinum, Annals of the Royal College of Surgeons of England. 89 (4) (pp 389-393).
  16. Mazur S. Hitchcock T. (2001). Spontaneous pneumomediastinum, pneumothorax and ecstasy abuse. Emergency Medicine. 13 (1) (pp 121-123).
  17. McCullough C et al., (2013). Pneumomediastinum secondary to mephedrone inhalation, BMJ Case Rep [online] 2013; doi:10.1136/bcr-2013-009961. Accessed 04/12/2015 via http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3702967/.
  18. Moorchilot R et al., (2008). Spontaneous pneumomediastinum after oral ingestion of ecstasy, Acute Medicine. 7 (1) (pp 37-38).
  19. Mortelmans L.J et al., (2005). Spontaneous pneumomediastinum and myocarditis following Ecstasy use: a case report, European journal of emergency medicine: official journal of the European Society for Emergency Medicine. 12 (1) (pp36-38).
  20. Mutlu H, et al., (2005). ‘Ecstasy’ (MDMA)-induced pneumomediastinum and epidural pneumatosis, Diagnostic and Interventional Radiology. 11 (3) (pp 150-151).
  21. Onal O et al., (2014). A Rare Cause of Spontaneous Pneumomediastinum: Ecstasy Ingestion. Turk Toraks Derg. 16: 198-200.
  22. Onwudike M. (1996). Ecstasy induced retropharyngeal emphysema. Journal of Accident and Emergency Medicine. 13 (5) (pp 359-361).
  23. Ozturk D et al., (2013). Pneumomediastinum following ecstacy use: Case report, Int J Med Invest. vol 2; num 4; 229-232.
  24. Pittman J.A.L. Pounsford J.C. (1997). Spontaneous pneumomediastinum and Ecstasy abuse. Journal of Accident and Emergency Medicine. 14 (5) (pp 335-336).
  25. Quin G.I. et al., (1999). Spontaneous pneumomediastinum and ecstasy abuse. Journal of Accident and Emergency Medicine. 16 (5) (pp 382).
  26. Ramirez E.M.I et al., (2014). A case report on MDMA-induced pneumothorax, pneumomediastinum, pneumorachis and subcutaneous emphysema, Respirology. Conference: 19th Congress of the Asian Pacific Society of Respirology Bali Indonesia. Conference Start: 20141113 Conference End: 20141116. Conference Publication: (var.pagings). 19 (pp 234).
  27. Rejali D et al., (2002). Pneumomediastinum following ecstasy (methylenedioxymetamphetamine, MDMA) ingestion in two people at the same ‘rave’. Journal of Laryngology and Otology. 116 (1) (pp 75-76).
  28. Rezvani K et al., (1996). Ecstasy induced pneumomediastinum. Thorax. 51 (9) (pp 960-961).
  29. Rothman R.B et al., (2001). Amphetamine-type central nervous system stimulants release norepinephrine more potently than they release dopamine and serotonin. Synapse. 2001;39:32–41.
  30. Soares D.S et al., (2015). Subcutaneous emphysema and pneumomediastinum following cocaine inhalation: A case report. Journal of Medical Case Reports. 9 (1), Article Number 195.
  31. Stull B.W. (2008). Spontaneous pneumomediastinum following ecstasy ingestion and sexual intercourse, Emergency Medicine Journal. 25 (2) (pp 113-114).
  32. Wood D.M et al., (2011). Variability in the 3,4methylenedioxymethamphetamine content of ‘ecstasy’ tablets in the UK. Emergency Medicine Journal. 28: 764-765.

Request Permissions

To request copyright permission to republish or share portions of our works, please visit Copyright Clearance Center’s (CCC) Marketplace website by clicking the button below:

Get Permission

Pneumomediastinum as a complication of MDMA (3,4-methylenedioxymetamfetamine, Ecstasy) ingestion

21st October 2016
PMID: 27759752
Authors Affiliations
Suleiman Ezoubi Department of Respiratory Medicine, Hull Royal Infirmary, Hull and East Riding Hospitals NHS Trust, Hull, UK.
Hassan Kahal Department of Diabetes and Endocrinology, York Hospital, York Teaching Hospital NHS Foundation Trust, York, UK.
W Stephen Waring Acute Medical Unit, York Teaching Hospitals NHS Foundation Trust

Pneumomediastinum as a complication of MDMA (3,4-methylenedioxymetamfetamine, Ecstasy) ingestion

Cite this article as:

Ezoubi S, Kahal H, Waring WS. Pneumomediastinum as a complication of MDMA (3,4-methylenedioxymetamfetamine, Ecstasy) ingestion. Acute Med. 2016;15(3):152-156. PMID: 27759752.

Pneumomediastinum as a complication of MDMA (3,4-methylenedioxymetamfetamine, Ecstasy) ingestion

Share this article

Click the icon of the social media platform on which you would like to share this article.


Shopping Basket
Scroll to Top