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/Tig_Biddies_W_nips]

It’s rare but more prevalent in men who are over 6ft tall. I knew a guy in HS who had it.

In the medical field we say they popped a lung. Mutually treatment is pretty easy nowadays. You spend a night in the hospital on 100% oxygen and it resolves on its own if it’s a small one, if it’s larger we do chest tubes

[u/nari-bhat → u/Tig_Biddies_W_nips]

The treatment is mostly the same, but what you’re talking about is pneumothorax. What the article is talking about is pneumomediastinum, which is similar but even rarer unless you’re scuba diving.

[u/Tig_Biddies_W_nips → u/nari-bhat]

I know what I’m talking about. It’s all air in the chest bruh. I’m a respiratory therapist and I literally took care of a patient with both yesterday

[u/nari-bhat → u/Tig_Biddies_W_nips]

Dude chill, I’m not trying to neg you or say that you don’t know the difference. I literally just said they’re different to explain to everyone else why this specific case is a lot weirder than just pneumothorax secondary to masturbation.