Deanne S Soares
Campbelltown Hospital, University of Western Sydney, Australia
Title: Subcutaneous emphysema and pneumomediastinum following cocaine inhalation: A case report
Biography
Biography: Deanne S Soares
Abstract
Introduction- Subcutaneous emphysema or pneumomediastinum can occur as a complication of illicit drug use although this is rare. When occurring without a pneumothorax and spontaneously, it is usually treated conservatively, but can have serious consequences. 
 Case presentation- Here we present an otherwise healthy 23-year-old Caucasian male who presented to the ED at our institution and was found to have both subcutaneous emphysema and pneumomediastinum, as a result of cocaine use. His only presenting symptom was mild chest pain and he had palpable subcutaneous crepitations. He underwent a series of investigations including a chest radiograph and CT as well as barium fluoroscopy study to rule out secondary pneumomediastinum, which can be fatal. The management involved a period of observation and supportive care. 
 Conclusion- This is a rare case of subcutaneous emphysema and pneumomedisatinum likely due to the nasal insufflation of cocaine. We discuss the necessary investigations to rule out any serious underlying pathology. These should be considered in patients who present with chest pain after cocaine use