# Spontaneous Pneumomediastinum and Cannabinoid Hyperemesis Syndrome: A Case Report and Literature Review > **Author:** Benjamin Caplan, MD (ABFM Board Certified, MA Lic. #240562, NPI: 1962722637) > **Publisher:** CED Clinic (https://cedclinic.com) > **Canonical URL:** https://cedclinic.com/spontaneous-pneumomediastinum-cannabinoid-hyperemesis-case-report/ > **Published:** 2026-03-20T17:27:37-04:00 | **Last Modified / Clinically Audited:** 2026-09-28T15:54:23-04:00 > **Clinical Summary:** Explore spontaneous pneumomediastinum as a rare complication of cannabinoid hyperemesis syndrome in this detailed case report and 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](https://cedclinic.com/cannabis-hyperemesis-syndrome-psychiatric-risk/) 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](https://cedclinic.com/cannabis-hyperemesis-syndrome-virginia-er-cases-surge/) syndrome. With CHS increasingly recognized in [clinical practice](https://cedclinic.com/cannabis-reproductive-health-women-clinical-evidence/), 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](https://cedclinic.com/cannabis-tolerance-behavioral-models/) who developed spontaneous pneumomediastinum secondary to forceful vomiting from [cannabinoid hyperemesis](https://cedclinic.com/cannabis-hyperemesis-syndrome-virginia-er-cases-surge/) 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. 💬 Join the Conversation Have a question about how this applies to your situation? [Ask Dr. Caplan →](https://benjamincaplan.com/ask-dr-caplan) Want to discuss this topic with other patients and caregivers? [Join the forum discussion →](https://cedclinic.com/interact/discussion-forums/) Have thoughts on this? Share it: [𝕏 Share on X](https://twitter.com/intent/tweet?text=Just%20read%20this%20on%20CEDclinic.com%3A%20Spontaneous%20Pneumomediastinum%20and%20Cannabinoid%20Hyperemesis%20Syndrome%3A%20A%20Case%20Repor...%20%40drcaplan&url=https%3A//pubmed.ncbi.nlm.nih.gov/41728401/)[in Share on LinkedIn](https://www.linkedin.com/sharing/share-offsite/?url=https%3A//pubmed.ncbi.nlm.nih.gov/41728401/)[🦥 Share on BlueSky](https://bsky.app/intent/compose?text=Just%20read%20this%3A%20Spontaneous%20Pneumomediastinum%20and%20Cannabinoid%20Hyperemesis%20Syndrome%3A%20A%20Case%20Repor...%20--%20via%20%40drcaplan.bsky.social%20https%3A//pubmed.ncbi.nlm.nih.gov/41728401/)[📷 Follow on Instagram](https://www.instagram.com/drbenjamincaplan/)[📝 Read more on Substack](https://substack.com/@doctorapproved)[🔔 Subscribe via RSS](https://cedclinic.com/category/cannabis-news/feed/) 📰 Source: [https://pubmed.ncbi.nlm.nih.gov/41728401/](https://pubmed.ncbi.nlm.nih.gov/41728401/) Table of Contents - [FAQ](#FAQ)[What caused pneumomediastinum in this young cannabis user?](#What_caused_pneumomediastinum_in_this_young_cannabis_user) - [How was the pneumomediastinum diagnosed and treated in this case?](#How_was_the_pneumomediastinum_diagnosed_and_treated_in_this_case) - [How often has CHS been linked to spontaneous pneumomediastinum?](#How_often_has_CHS_been_linked_to_spontaneous_pneumomediastinum) - [Can the vomiting in CHS lead to more serious complications?](#Can_the_vomiting_in_CHS_lead_to_more_serious_complications) - [Related](#Related) ## FAQ ### What caused pneumomediastinum in this young cannabis user? The case report attributes it to forceful vomiting from cannabinoid hyperemesis syndrome (CHS). The patient was an 18-year-old male with six months of [chronic cannabis use](https://cedclinic.com/cannabis-tolerance-behavioral-models/), and the pneumomediastinum developed spontaneously as a result of his severe vomiting episodes. ### How was the pneumomediastinum diagnosed and treated in this case? CT imaging showed air in the mediastinum and no perforation of the esophagus. With no perforation found, the patient was managed conservatively, using bowel rest, antibiotics and supportive care, according to the case report. ### How often has CHS been linked to spontaneous pneumomediastinum? Rarely. This is only the fifth documented case in the literature linking cannabinoid hyperemesis syndrome to spontaneous pneumomediastinum. The report adds to a limited body of literature describing it as a rare but serious complication of the syndrome. ### Can the vomiting in CHS lead to more serious complications? Yes, according to this case. It highlights that severe vomiting episodes in cannabinoid hyperemesis syndrome can lead to complications beyond the typical gastrointestinal symptoms, as happened here with pneumomediastinum. The report notes this requires clinicians to keep a broader range of possible diagnoses in mind. {“@context”: “https://schema.org”, “@type”: “ScholarlyArticle”, “headline”: “Spontaneous Pneumomediastinum and Cannabinoid Hyperemesis Syndrome: A Case Report and Literature Review.”, “url”: “https://pubmed.ncbi.nlm.nih.gov/41728401/”, “about”: “cureus [clinical study](https://cedclinic.com/cannabis-hyperemesis-syndrome-psychiatric-risk/) spontaneous pneumomediastinum cannabinoid”, “isPartOf”: “Cureus”} [https://cedclinic.com/contact/](https://cedclinic.com/contact/) Physician-Led, Whole-Person Care A doctor who takes the time to truly understand you. Personal care that starts with listening and is guided by experience and ingenuity. 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[Read More](https://cedclinic.com/scromiting-disorder-cannabis-habit-risk/) [Cannabis for Nausea and Anxiety During Cancer Treatment](https://cedclinic.com/cannabis-nausea-anxiety-cancer-treatment-insights/) Explore how cannabis is used to manage nausea and anxiety, contrasting with complications like CHS. [Explore Now](https://cedclinic.com/cannabis-nausea-anxiety-cancer-treatment-insights/) New Studies Illuminate Health Effects of [Cannabis Use](https://cedclinic.com/cannabis-cardiovascular-health-insights-2024/) Review recent research highlighting both benefits and risks of cannabis consumption. Discover Insights ### Related --- ### Verification & Medical Governance - **Lead Clinical Author:** Benjamin Caplan, MD - **Credentials:** Board Certified in Family Medicine (ABFM), Former CMO Canna Care Docs (250,000+ patients supervised), Founder & CMO CED Clinic & CED Foundation, Author of *The Doctor-Approved Cannabis Handbook* (Penguin Random House). - **Clinical Scale:** 350,000+ lifetime evaluations overseen; 81,008-patient Real-World Evidence Registry (`~/.ced_rwe_vault.db`); 125,000+ peer-reviewed study literature observatory (`http://localhost:8768/api/explorer/terminal`). - **License Verification:** Commonwealth of Massachusetts License #240562 (https://checkahealthlicense.mass.gov/). - **NPI Registry:** 1962722637 (https://npiregistry.cms.hhs.gov/provider-view/1962722637). - **Ethics & Data Privacy:** Clinical registry observations adhere strictly to HIPAA Safe Harbor de-identification (45 CFR § 164.514(b)) and criteria for secondary research exemption under 45 CFR § 46.104(d)(4).