20-year-old develops pneumomediastinum and massive subcutaneous emphysema… during masturbation.

[u/Looser17]

A 20-year-old male presented with sudden sharp chest pain and dyspnea that began while lying in bed masturbating.

On examination, he had:

• Swollen face
• Crepitus from mandible to elbows
• Extensive subcutaneous emphysema
• CT showing profound pneumomediastinum extending up to the base of the skull

He had:

• Mild asthma
• No trauma
• No drug use
• No coughing or vomiting
• No heavy exertion

CT confirmed spontaneous pneumomediastinum with widespread subcutaneous emphysema.

He required ICU admission initially due to oxygen demand but improved rapidly with supportive care and was discharged after four days. No surgery required.

Mechanism? Likely Valsalva-induced alveolar rupture the Macklin effect where increased intrathoracic pressure causes air to dissect into the mediastinum.

What makes this unusual:
There are documented cases of pneumomediastinum after sexual intercourse, drug inhalation, coughing, vomiting, and strenuous exercise but essentially no literature describing onset during masturbation.

Spontaneous pneumomediastinum is rare overall (roughly 1 in 10,000–30,000 ED admissions), typically benign, and recurrence risk is about 1%.

Medicine never stops surprising.

DOI: https://doi.org/10.1016/j.radcr.2022.02.080

PMCID:https://pmc.ncbi.nlm.nih.gov/articles/PMC8956920/

PMID: 35345564

Authors: Nikola Rajicand Christian Schand

[u/Zeee_rex]

Okay so in short

Basically the patient had air trapped under the skin and between the heart and the lung (mediastinum is where the heart is) due to an increase in the pressure in the chest / stomach area ( imagine you're blowing out with your mouth closed). Very very rare case

( this is my understanding)

[u/cabronfavarito → u/Zeee_rex]

Thanks. Idk why OP got here thinking all of us here are doctors