Table 1: Clinical Symptoms and Signs, Radiographic Features, and Outcome of Crack Cocaine Smokers with Barotrauma

Age/Sex [Ref]

Onset after smoking

Other drugs used

Symptoms & Signs

Radiographic changes

Outcome

1. 26/F [10]

6 hr

Cigarettes, 1-2 ppd

Pleuritic chest pain, Hamman's sign

Bilateral PT* & PM**

Spontaneous resolution over several da

2. 19/F [10]

1 1/2 hr

Cigarettes & marijuana

Rt pleuritic chest pain

PM

Spontaneous resolution

3. 21/M [11]

12 hr

--

Sore throat, pleuritic chest pain, dyspnea

PM & IE***

Spontaneous resolution, 2 da

4. 21/M [12]

6 hr

Cigarettes, 1/2 ppd

Neck & precordial pain, dyspnea

PM, IE

Spontaneous resolution

5. 23/M [13]

Immediate

--

Hoarseness, dyspnea, chest pain, stiff neck

PM, pneumopericardium, IE, PT

Spontaneous resolution

6. 26/M [14]

Immediate

--

Neck swelling, chest pain, voice change

PM, IE

Spontaneous resolution, 4 da

7.-9. 3 cases: 2 M/1 F [8]

--

--

Dysphagia, chest pain, neck pain, dyspnea, muffled voice, subcutaneous emphysema, Hamman's sign (2)

PM, IE

Spontaneous resolution, 24-36 hr

10. 21/M [9]

2 hr

--

Substernal pleurisy, Hamman's sign

PM

Spontaneous resolution

11. 19/M [15]

--

--

Dyspnea, dizziness, mild headache, Hamman's sign

PM & subcutaneous emphysema

Spontaneous resolution

12. 20/M [15]

--

--

Pleuritic chest pain, Hamman's sign

PM & L. PT

Treated with tube thoracostomy when pain continued for 4 da

*PT = pneumothorax, **PM = pneumomediastinum, ***IE = interstitial emphysema

Discussion