Pneumorachis and pneumomediastinum caused by repeated Müller's maneuvers: Complications of marijuana smoking

摘要: Abstract Pneumomediastinum may occur during marijuana inhalation but only rarely has pneumorachis (epidural pneumatosis or aerorachia) been reported. The usual mechanisms that produce pneumomediastinum include severe acute asthma, toxic-induced bronchial hyperreactivity, and barotrauma caused by Valsalva's maneuver (expiration through resistance). We report a case in which resulted from repeated deep inspiration device with airflow resistance equivalent to Muller's maneuver. Inspiration occurred homemade apparatus resembling narrow outlet bong 2 piled compartments. combined subcutaneous emphysema occurred, without identified pneumothorax. There were no neurologic complications. Because of the absence bronchospasm, expiration either actively against closed glottis, apnea, this phenomenon is likely result maneuvers. Successive could have extreme negative intrathoracic pressure, would transmural pressure gradient inducing release extrarespiratory air. High-concentration oxygen therapy achieve nitrogen washout was used. [Hazouard E, Koninck J-C, Attucci S, Fauchier-Rolland F, Brunereau L, Diot P. Pneumorachis maneuvers: complications smoking. Ann Emerg Med. December 2001;38:694-697.]