[Pneumothorax following recreational inhalation of nitrous oxide].

A 21-year-old man was hospitalized with left-sided chest pain and found to have a collapsed lung (pneumothorax) that resolved after drainage. He had been regularly inhaling nitrous oxide for its mind-altering effects at rave parties. Repeated nitrous oxide exposure can cause blood, nerve, and birth defects. Rare pneumothorax cases have been reported during medical use when gas moves from the abdomen to the chest. Illicit use is uncommon and mostly seen in medical workers, but its spread to the public may cause accidents and unexpected side effects. Inhaled nitrous oxide can worsen an existing but unnoticed pneumothorax, with potentially serious consequences due to ignorance of risks.

Study at a glance

Abstract

A 21 year old man was admitted to hospital as an emergency complaining of left sided chest pain. Chest radiograph revealed a complete non compressive left-sided pneumothorax which resolved following thoracic drainage. A more detailed history revealed repeated and regular use of nitrous oxide by inhalation, for its consciousness-altering effect during rave parties. The principal side effects occurring as a consequence of repeated exposures to nitrous oxide are haematological, neuropsychiatric and teratogenic. Rare cases of pneumothorax have been described associated with the use of nitrous oxide occurring as complications of anaesthesia or during laparoscopy where gas diffuses from the abdominal to the pleural cavity. Illicit use of nitrous oxide is rare and usually occurs in medical workers. Its spreading to the public may lead to accidents and unanticipated side effects. Inhaled nitrous oxide can reveal asymptomatic pneumothorax by worsening it. The consequences can be dramatic in case of illicit use because of ignorance of side effects.