"Usual" cannabis abuse producing unusual consequences

Beitrag in einer Fachzeitschrift

Details zur Publikation

Autorinnen und Autoren: Sieber C
Zeitschrift: Deutsche Medizinische Wochenschrift
Jahr der Veröffentlichung: 2007
Band: 132
Heftnummer: 11
Seitenbereich: 560-562
ISSN: 0012-0472


Case history: A 17-year-old male presented in an agitated,.deranged state with rapidly increasing swelling of the neck. Except for regular abuse of cannabis there was no medical history of note. He had a sinus tachycardia (130 bpm), a slow pupillary reflex, bilateral hyposphagma and subcutaneous emphysema around the neck and shoulders.Investigations and diagnosis: Laboratory tests showed elevated inflammatory markers. The chest X-ray demonstrated a bilateral pneumothorax and large subcutaneous emphysema. Subsequent computed tomography of neck and thorax showed an extensive pneumomediastinum and the described subcutaneous emphysema. There was no evidence of a ruptured trachea or esophageal perforation. The underlying cause was presumed to have been a Valsalva maneuver during marijuana smoking.Treatment and course: As the pneumothorax was completely reabsorbed, no chest drains were inserted and the patient was transferred to our toxicological intensive care unit. Recurring drug-induced psychosis had to be treated with repeated doses of haloperidol. The emphysema was slowly reabsorbed without any further complication. The patient was transferred back to a psychiatric ward after five days.Conclusion: Although cannabis is thought to be one of the "safe" drugs, its abuse can have life-threatening effects. One complication is the occurrence of a pneumothorax after a Valsalva maneuver. As the rate of cannabis abuse has been increasing during the last few years, the risk of life-threatening complications should be mentioned in relevant publications and as part of drug education Patients presenting with dyspnea should always be carefully questioned about possible drug abuse.

FAU-Autorinnen und Autoren / FAU-Herausgeberinnen und Herausgeber

Sieber, Cornel Prof. Dr.
Lehrstuhl für Innere Medizin (Geriatrie)

Zuletzt aktualisiert 2018-09-11 um 06:02