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Review
. 2007 May;89(4):389-93.
doi: 10.1308/003588407X183373.

Ecstasy-associated pneumomediastinum

Silvana F Marasco  1 , H Kiat Lim
Affiliations
Review

Ecstasy-associated pneumomediastinum

Silvana F Marasco et al. Ann R Coll Surg Engl. 2007 May.

Abstract

Introduction: Ecstasy, also known as MDMA (3,4, methylenedioxymethamphetamine), is a popular illicit party drug amongst young adults. The drug induces a state of euphoria secondary to its stimulant activity in the central nervous system.

Patients and methods: A database review at two major inner city hospitals was undertaken to identify patients presenting with pneumomediastinum and their charts reviewed. A Medline review of all reported cases of pneumomediastinum associated with ecstasy abuse was undertaken.

Results: A total of 56 patients presenting with pneumomediastinum were identified over a 5-year period. Review of the charts revealed a history of ecstasy use in the hours prior to presentation in six of these patients, representing the largest series reported to date.

Conclusions: Review of previously reported cases reveals the likely mechanism is due to Valsalva manoeuvre during periods of extreme physical exertion, and not a direct pharmacological effect of the drug.

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Figures

Figure 1
Figure 1
Pneumomediastinum on computed tomography scan.
Figure 2
Figure 2
Pericardial air leading to the classical sign of Hamman's crunch.
See this image and copyright information in PMC

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