Heavy Cannabis Use Leads to Rare Chest Complication from Severe Vomiting | Research

The takeaway

An 18-year-old with a 6-month history of chronic marijuana use developed spontaneous pneumomediastinum (air in the chest cavity) from forceful vomiting caused by cannabinoid hyperemesis syndrome — only the fifth such case reported.

Emergency physicians, gastroenterologists, radiologists, and clinicians managing cannabinoid hyperemesis syndrome.

What the researchers found

An 18-year-old male with chronic cannabis use presented with chest pain, shortness of breath, and abdominal pain; CT revealed mediastinal air without esophageal perforation, consistent with spontaneous pneumomediastinum caused by CHS-related forceful vomiting. He was managed conservatively and recovered.

Why it matters

Spontaneous pneumomediastinum can mimic life-threatening conditions like esophageal perforation — recognizing CHS as a cause can prevent unnecessary invasive procedures and guide appropriate management.

The numbers in context

18-year-old male; 6 months of chronic cannabis use; only 5th reported case of CHS-induced SPM; managed conservatively with bowel rest, IV antibiotics, and supportive care

How the study worked

Single case report with CT imaging, esophagram confirmation, conservative management, and literature review of the CHS-SPM association.

What this study cannot tell us

Single case report; cannot establish prevalence; may be underreported; conservative management typical for SPM regardless of cause; no long-term follow-up reported; cannabis use history based on patient report.

How to read the evidence

Single case report contributes to an emerging pattern but provides the lowest level of clinical evidence.

When this study was published

Published 2026; adds to a small but growing case series.

The bigger picture

As CHS prevalence grows with increasing cannabis use, emergency physicians should add CHS to the differential for young patients presenting with chest pain and mediastinal air.

Questions still open

How often does CHS cause pneumomediastinum? Should all young patients with SPM be screened for cannabis use? Does the severity of CHS-induced vomiting predict complication risk?

Common questions

Can CHS cause dangerous complications?

Yes — forceful vomiting from CHS can cause spontaneous pneumomediastinum (air leaking into the chest cavity), which presents with chest pain and shortness of breath. This is the 5th reported case of this complication.

What is spontaneous pneumomediastinum?

It occurs when air leaks from the lungs or airways into the space around the heart (mediastinum), typically from forceful coughing or vomiting. While usually manageable conservatively, it must be distinguished from more dangerous conditions like esophageal perforation.

Read the original research

Spontaneous Pneumomediastinum and Cannabinoid Hyperemesis Syndrome: A Case Report and Literature Review.

Cureus, 18(1), e101979

View on PubMed ↗Publisher’s paper ↗

Citation

Jafry, Baqir; Chillag, Shawn. (2026). Spontaneous Pneumomediastinum and Cannabinoid Hyperemesis Syndrome: A Case Report and Literature Review.. Cureus, 18(1), e101979. https://doi.org/10.7759/cureus.101979