PDF(Pubmed)
Abstract：
BACKGROUND There has been an increase in the use of inhalation methods to abuse drugs, including freebasing crack cocaine (alkaloid) and inhaling methamphetamine vapor. This report is of a 25-year-old man with a history of substance abuse presenting with pneumomediastinum due to methamphetamine vapor inhalation. Acute pneumomediastinum is an extremely rare complication of methamphetamine use. CASE REPORT A 25-year-old man was treated for polysubstance abuse following 9 days of methamphetamine abuse. EKG did not show any ST &T change. D-dimer was normal, at 0.4 mg/L, so we did not do further work-up for pulmonary embolism. His chest pain worsened in the Emergency Department (ED), and a physical exam demonstrated crepitation of the posterior neck, trapezius, and right scapula. A portable chest X-ray revealed subcutaneous air over the right scapular region, in addition to pneumomediastinum. The urine drug screen test was positive for methamphetamine. A chest CT was ordered, which showed a moderate-volume pneumomediastinum with soft-tissue air tracking into the lower neck and along the right chest wall. The patient underwent an esophagogram, which showed no air leak, and Boerhaave\'s syndrome was ruled out. His symptoms improved and he did not require any surgical intervention. CONCLUSIONS Considering the higher rates of illicit substance use, especially methamphetamine, it is important to pay attention to the associated pathologies and to keep spontaneous pneumomediastinum on the list of differentials for patients using methamphetamine, particularly those who inhale it, which can cause pneumomediastinum, even without Boerhaave\'s syndrome.
摘要：
背景技术滥用药物的吸入方法的使用有所增加。包括释放快克可卡因（生物碱）和吸入甲基苯丙胺蒸气。该报告是关于一名25岁的男子，有药物滥用史，由于吸入甲基苯丙胺蒸气而出现纵隔肺炎。急性纵隔肺炎是使用甲基苯丙胺的极为罕见的并发症。病例报告一名25岁男子在滥用甲基苯丙胺9天后接受了多物质滥用治疗。心电图没有显示任何ST&T变化。D-二聚体正常,在0.4毫克/升，所以我们没有做肺栓塞的进一步检查。他的胸痛在急诊科(ED)加重,体格检查显示后颈起皱，斜方肌,和右肩胛骨。便携式胸部X光检查显示右肩胛骨区域有皮下空气，除了纵隔肺炎。尿药物筛查试验对甲基苯丙胺呈阳性。要求做胸部CT,显示中等体积的纵隔气肿，软组织空气追踪进入下颈部和右胸壁。病人做了食管造影检查,没有空气泄漏，Boerhaave的综合症被排除了.他的症状有所改善，不需要任何手术干预。结论考虑到非法药物使用率较高，尤其是甲基苯丙胺,重要的是要注意相关的病理，并将自发性纵隔气肿保留在使用甲基苯丙胺的患者的差异列表中，尤其是那些吸入它的人，会导致纵隔气肿，即使没有Boerhaave综合征.
