A 15-year-old with mild asthma developed subcutaneous emphysema, pneumomediastinum, and pneumorrhachis (air in the spinal canal) after vaping and cannabis inhalation, representing one of the youngest reported EVALI air leak cases.
Pediatric emergency physicians, adolescent medicine specialists, pulmonologists
One of the youngest reported EVALI air leak cases
What the researchers found
A 15-year-old male with mild asthma presented with acute respiratory distress, hypoxemia, and neck/face swelling after using vaping products and inhaling cannabis. Imaging confirmed widespread air leaks including subcutaneous emphysema, pneumomediastinum, and pneumorrhachis (air in the spinal canal) without esophageal perforation. Conservative management with oxygen, TPN, antibiotics, and supportive care led to full recovery.
Why it matters
This is one of the youngest reported cases of EVALI-associated air leak syndrome. As vaping prevalence rises sharply among adolescents, clinicians seeing chest pain and respiratory distress in young patients need to consider vaping-related complications in their differential diagnosis.
The numbers in context
15-year-old male; mild asthma history; subcutaneous emphysema + pneumomediastinum + pneumorrhachis; full recovery with conservative management
How the study worked
Single case report with literature review. Targeted literature search identified several reports linking vaping to spontaneous air leak syndromes.
What this study cannot tell us
Single case report cannot establish frequency or causation. Combined cannabis and vaping use makes it impossible to attribute the complication to one substance. Mild asthma may have been a contributing factor.
How to read the evidence
Single case report documents a rare complication in an age group where it is particularly underrecognized, but cannot establish incidence or risk factors.
When this study was published
2025 publication
The bigger picture
The EVALI epidemic of 2019-2020 highlighted acute lung injuries from vaping, but air leak syndromes remain underrecognized as part of this spectrum. Adolescents may be particularly vulnerable due to ongoing lung development and higher rates of vaping initiation.
Questions still open
- Does asthma increase the risk of vaping-related air leak complications? Are adolescents more susceptible to these complications than adults?
Common questions
What is pneumorrhachis?
Was this caused by cannabis or vaping?
Read the original research
Potential Association of Air Leak Syndromes With E-cigarette or Vaping Product Use-Associated Lung Injury (EVALI).
Cureus, 17(9), e93395
Citation
Anakebe, Chidi; Abdallah, Ragda; Abdalla, Mahil; Taha, Fatima; Khan, Haji Sheeraz. (2025). Potential Association of Air Leak Syndromes With E-cigarette or Vaping Product Use-Associated Lung Injury (EVALI).. Cureus, 17(9), e93395. https://doi.org/10.7759/cureus.93395
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