Spontaneous Pneumomediastinum as the Result of Marijuana Use

Spontaneous pneumomediastinum is the pathologic presence of extraluminal gas within the mediastinum with an unclear cause. It typically has a spontaneously resolving course and has been associated increasingly with marijuana use, coinciding with the growing prevalence of marijuana use. Several proposed causative mechanisms include Valsalva and Müller maneuvers, associated vomiting, and induced physiologic changes. We present a case of a 37-year-old man with a medical history of alcohol and marijuana use disorder who presented with intractable vomiting and intermittent hematemesis and was found to have spontaneous pneumomediastinum.