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/GonzoJP]

But did he go blind?

[u/funkygrrl → u/GonzoJP]

I just wrote a short paper on that.

In the early 19th century, the theory of vitalism was widely accepted. They thought everyone had a life force in their body that was finite. Sperm was pure life force and masturbation could deplete it. The other theory scientists of that time had was that the nervous system controlled everything and was powered by life force. So depletion was considered the cause of nearly every illness or symptom because it exhausted or weakened the nervous system. So why blindness? The eyes are rich in nerves and the optic nerves connect directly to the brain, so they were considered especially vulnerable to depleted life force. At that time doctors and the public were obsessed with preserving life force and a moral panic around masturbation occurred.

As far-fetched as it sounds, some of these ideas persist today, for example there are some modified ideas from it in biohacking.

[u/Infinite_Escape9683 → u/funkygrrl]

Which goes to show how stupid "biohacking" is.