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Question
Patient presents with chest pain after smoking crack cocaine; what's the diagnosis?
Answer
Pneumomediastinum secondary to crack cocaine inhalation
Causes of Pneumomediastinum
- Tracheal or bronchial perforation (e.g., trauma s/p bronchoscopy)
- Mediastinitis (e.g., rapidly descending dental infections)
- Esophageal perforation (e.g., Boerhaave syndrome or post-endoscopy)
- Mediastinal trauma (e.g., stab wound to chest)
- Rupture of lung parenchyma
- Ruptured bleb (e.g., COPD exacerbation)
- Valsalva maneuver (e.g., smoking illicit substances or childbirth)
- Barotrauma (e.g., mechanical ventilation or severe asthma exacerbation)
- Scuba Diving
References
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