Vaping associated spontaneous pneumothorax - A case series of an enigmatic entity!

TL;DR: A 24 year old man who was a dual user of tobacco smoke and e-cigarette presented with one month history of right sided pleuritic chest pain associated with cough and shortness of breath a week prior to the admission as discussed by the authors .

Abstract: Spontaneous pneumomediastinum, also called Hamman's syndrome, is an uncommon condition that results from alveolar rupture with air tracking into the mediastinum. It is usually triggered by events that raise intrathoracic pressure, but because of its rarity, it is often overlooked and may initially be confused with more serious conditions. The prognosis is generally excellent, as most cases resolve without intervention. We describe the case of a woman in her early 20s, with a history of regular e-cigarette use, who developed acute chest pain, shortness of breath, vomiting, and difficulty swallowing during an influenza A infection. Initial chest radiography demonstrated subcutaneous emphysema, pneumomediastinum, and a small left apical pneumothorax, raising concern for Boerhaave syndrome. CT confirmed pneumomediastinum without evidence of oesophageal perforation, which was further excluded by a water-soluble contrast swallow study. A viral screen was positive for influenza A. She was managed conservatively with broad-spectrum antimicrobials, oseltamivir, nil by mouth, and parenteral nutrition until Boerhaave syndrome was excluded, followed by gradual reintroduction of diet and supportive therapy. Her symptoms resolved completely. This case highlights the potential synergistic effect of viral respiratory infection and vaping in precipitating Hamman's syndrome in otherwise healthy young adults and underscores the importance of distinguishing this benign entity from life-threatening differential diagnoses such as oesophageal rupture.

TL;DR: A 15-year-old male developed bilateral spontaneous pneumothorax after 6 months of vaping cannabis concentrate, highlighting the risk of vaping-associated spontaneous pneumothorax (VASP) in adolescents, particularly with increasing cannabis concentrate use.

TL;DR: Pneumothorax secondary to a traumatic Brazilian Jiu-Jitsu injury can occur in healthy individuals and should be recognized by clinicians in athletes participating in the sport.

TL;DR: Because of the associations between diacetyl and bronchiolitis obliterans and other severe respiratory diseases observed in workers, urgent action is recommended to further evaluate this potentially widespread exposure via flavored e-cigarettes.

TL;DR: An overview of relevant and updated information on epidemiology, pathophysiology and cause(s) of spontaneous (primary and secondary) pneumothorax is described.

TL;DR: Although the primary outcome was not statistically robust to conservative assumptions about missing data, the trial provides modest evidence that conservative management of primary spontaneous pneumothorax was noninferior to interventional management, with a lower risk of serious adverse events.

TL;DR: Four men with multiple large upper zone lung bullae but otherwise relatively preserved lung parenchyma had a history of significant exposure to marijuana, suggesting a possible causal role for marijuana in the pathogenesis of this unusual pattern of bullous emphysema.