Hirsutism + Spironolactone –> Retching –> Pneumomediastinum

A previously unknown chain of events can lead to pneumomediastinum (pneumomediastinum is air in the mediastinum — the space in the middle of the chest, between the lungs), says this new study:

Pneumomediastinum after retching,” Behcet Al, Cuma Yildirim, Suat Zengin, Cavdar Murat, Sinan Genc, Maruf Sanli, BMJ Case Reports 2012;10.1136/bcr.03.2009.1647. The authors, at Gaziantep University Hospital, Gaziantep, Turkey, report:

“A 25-year-old woman with hirsutism presented to the Emergency Department of the medicine faculty in Gaziantep University… The x-ray study and CT scan of the chest revealed pneumomediastinum. The patient reported that 6 h before presentation she took spironolactone due to hirsutism and she retched. Retching caused the symptoms.”