Abstract

Cervical emphysema and pneumomediastinum are rare con- ditions, especially outside the setting of blunt trauma. Here we describe a case of a 31-year-old male with a history of cocaine use presenting with cough, odynophagia, neck pain, and neck swelling after forcefully blowing his nose to relieve cocaine-associated congestion and obstruc- tion. Physical exam demonstrates crepitus along the neck and clavicu- lar regions. Imaging shows cervical emphysema, pneumomediastinum, and a nasopharyngeal fistula. We discuss presentation, causes, diagno- sis, and management of cervical emphysema and pneumomediastinum.

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