First reported case of air leaking into the spine from cannabis hyperemesis vomiting | Research

The takeaway

A young patient with cannabinoid hyperemesis syndrome developed both pneumomediastinum (air in the chest cavity) and pneumorrhachis (air around the spinal cord), the first reported case combining CHS with spinal air leak.

Emergency physicians, gastroenterologists, and heavy cannabis users aware of CHS symptoms.

First-ever case of spinal air leak from CHS vomiting

What the researchers found

This is the third reported case of CHS with associated pneumomediastinum and the first documented case of pneumorrhachis (air in the spinal canal) linked to CHS. The complications resulted from forceful, repeated vomiting associated with the syndrome.

Why it matters

CHS is becoming more common as cannabis use increases. Severe vomiting can cause rare but serious mechanical complications, and clinicians need to consider these possibilities when evaluating CHS patients with unusual symptoms.

The numbers in context

Third case of CHS with pneumomediastinum in the literature. First case of CHS with pneumorrhachis ever reported.

How the study worked

Single case report with literature review.

What this study cannot tell us

Single case report. Cannot establish frequency or risk factors for these complications in CHS. No long-term follow-up reported.

How to read the evidence

Single case report documenting a novel complication.

When this study was published

Published in 2022.

The bigger picture

As CHS diagnoses increase with rising cannabis use, rare complications that were once one-off curiosities may become clinically significant patterns worth screening for.

Questions still open

How often do CHS patients develop pneumomediastinum or other mechanical complications from severe vomiting? Should imaging be standard for CHS patients with chest or back pain?

Common questions

Can cannabinoid hyperemesis cause serious complications?

Yes. This case report documents air leaking into the chest cavity and spinal canal from forceful vomiting caused by CHS, a rare but potentially dangerous mechanical complication.

What is pneumorrhachis?

Pneumorrhachis is the presence of air within the spinal canal. In this case, it resulted from severe, repeated vomiting associated with cannabinoid hyperemesis syndrome.

Read the original research

Pneumomediastinum and Pneumorrhachis Associated With Cannabinoid Hyperemesis Syndrome.

Cureus, 14(12), e32380

View on PubMed ↗Publisher’s paper ↗

Citation

Hernandez Garcia, Laura R; Kemper, Suzanne; Chillag, Shawn A. (2022). Pneumomediastinum and Pneumorrhachis Associated With Cannabinoid Hyperemesis Syndrome.. Cureus, 14(12), e32380. https://doi.org/10.7759/cureus.32380