J Korean Soc Emerg Med.  2023 Oct;34(5):462-466.

Spontaneous pneumomediastinum induced by electronic cigarette use that could have been mistaken for secondary pneumomediastinum due to underlying Crohn’s disease

• Noh HS
• Kim MJ
• Choe YH
• Kwon Y

Abstract

Objective
This case report was intended to report on a rare cause of spontaneous pneumomediastinum (SPM).
Methods
When a patient with Crohn's disease (CD) visited our hospital for pneumomediastinum, a disease activity evaluation was performed, and specific questions were asked to identify possible causes of SPM.
Results
The disease status of CD was confirmed as in active by evaluation. Specific questions about situations requiring the Valsalva maneuver, including vigorous exercise, lifting heavy objects, and difficult stool passage, were asked, but none were applicable. When asked an open question regarding incidents related to deep breathing, the patient answered that he had recently started smoking an electronic cigarette which required taking deep breaths.
Conclusion
Even when there is an underlying disease, specific history-taking is important if the possibility of complications related to the underlying disease is low. A new wave of previously unseen complications has emerged in parallel with increased electronic cigarette use.

Keyword

Crohn’s disease; Diagnostic pneumomediastinum; Electronic cigarette; Emphysema