Cocaine-induced cervical emphysema and pneumomediastinum

Abstract EN

Cervical emphysema and pneumomediastinum are rare conditions, especially outside the setting of blunt trauma.

Here we describe a case of a 31-year-old male with a history of cocaine use presenting with cough, odynophagia, neck pain, and neck swelling after forcefully blowing his nose to relieve cocaine-associated congestion and obstruction.

Physical exam demonstrates crepitus along the neck and clavicular regions.

Imaging shows cervical emphysema, pneumomediastinum, and a nasopharyngeal fistula.

We discuss presentation, causes, diagnosis, and management of cervical emphysema and pneumomediastinum.