IngentaConnect Ecstasy-associated pneumomediastinum

Authors: Marasco, Silvana F.¹; Lim, H Kiat²

Source: Annals of The Royal College of Surgeons of England, Volume 89, Number 4, May 2007 , pp. 389-393(5)

Publisher: The Royal College of Surgeons of England

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.

Keywords: MEDIASTINAL EMPHYSEMA; N-METHYL-3; 4-METHYLENEDIOXYAMPHETAMINE; ECSTASY

Document Type: Research article

DOI: 10.1308/003588407X183373

Affiliations: 1: Department of Cardiothoracic Surgery, The Alfred and Royal Melbourne Hospitals, Australia 2: Department of Surgery, Monash University, Melbourne, Australia

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