Spontaneous Pneumomediastinum and Cannabinoid Hyperemesis Syndrome: A Case Report and Literature Review.

CED Clinical Relevance  #64Notable Clinical Interest  Emerging findings or policy developments worth monitoring closely.
🔬 Evidence Watch  |  CED Clinic
ChsCannabis ComplicationsPneumomediastinumCase ReportEmergency Medicine
Journal Cureus
Study Type Clinical Study
Population Human participants
Why This Matters

This case report adds to the limited literature documenting spontaneous pneumomediastinum as a rare but serious complication of cannabinoid hyperemesis syndrome. With CHS increasingly recognized in clinical practice, understanding its potential complications helps clinicians provide comprehensive care and appropriate monitoring.

Clinical Summary

This case report describes an 18-year-old male with six months of chronic cannabis use who developed spontaneous pneumomediastinum secondary to forceful vomiting from cannabinoid hyperemesis syndrome. CT imaging revealed mediastinal air without esophageal perforation, and the patient was managed conservatively with bowel rest, antibiotics, and supportive care. This represents only the fifth documented case linking CHS to spontaneous pneumomediastinum in the literature. The case highlights how severe vomiting episodes in CHS can lead to complications beyond the typical gastrointestinal symptoms, requiring clinicians to maintain broader differential considerations.

Dr. Caplan’s Take

“While pneumomediastinum remains an exceptionally rare CHS complication, this case reinforces why I counsel patients about the syndrome’s potential severity and emphasize cannabis cessation as the definitive treatment. The rarity shouldn’t diminish our vigilance for complications in patients with severe, prolonged vomiting episodes.”

Clinical Perspective
🧠 Clinicians should maintain awareness that CHS can present with complications beyond typical cyclic vomiting, particularly in patients with severe or prolonged episodes. When evaluating chest pain in young cannabis users with vomiting history, pneumomediastinum should be considered in the differential diagnosis, though conservative management often suffices when esophageal perforation is excluded.

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This study item was assembled from normalized source metadata and pipeline scoring.






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