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Minerva Pneumologica 2019 March;58(1):36-44

DOI: 10.23736/S0026-4954.19.01846-7


language: English

Pulmonary complications after cocaine abuse: a case series

Alberto BRUNO 1, Rosalia GARGANO 2, Domenico ALBANO 1, Lorenzo TESÈ 3, Dario GIAMBELLUCA 1, Claudio LETO 1, Giuseppe CUTAIA 1, Gaetano TOSTO 1, Lucrezia BRUNO 4, Leonardo SALVAGGIO 1, Massimo GALIA 1, Massimo MIDIRI 1, Giuseppe SALVAGGIO 1

1 Department of Radiology, Department of Biopathology and Medical Biotechnologies (DIBIMED), University of Palermo, Palermo, Italy; 2 Department of Otorhinolaryngology, BIONEC, University of Palermo, Palermo, Italy; 3 Department of Radiology, Ospedali Riuniti Villa Sofia Cervello Hospital, Palermo, Italy; 4 Pediatric Unit, University of Palermo, Palermo, Italy

Cocaine is the most commonly used illicit drug among patients seen in emergency rooms. It can be taken orally, intranasally, intravenously, or can be smoked. Nevertheless, over the last years, smoking crack cocaine turned into the most common assumption method since it is cheap and carries more amounts of drug to the lungs producing an immediate and intense euphoria. Subcutaneous emphysema, pneumomediastinum, tracheal and bronchial lacerations and pneumorrhachis are uncommon complications of cocaine abuse that occurs more commonly when cocaine is smoked but can also occur when cocaine is inhaled. Radiological examination, especially computer tomography, plays a crucial role in the identification and characterization of these complications. We report the radiological findings of four patients admitted to our emergency department with pulmonary complications after using cocaine with different drug administration route. We also describe the role of some tools like virtual bronchoscopy and minimum intensity projection generated from the computer tomography image data sets in the identification of tracheobronchial lacerations.

KEY WORDS: Crack cocaine - Diagnostic pneumomediastinum - Mediastinal emphysema - Pneumorrhachis - X-ray computed tomography

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