Pneumomediastinum simulating a panic attack in a patient with anorexia nervosa.

OBJECTIVE

Pneumomediastinum is a rare complication of anorexia nervosa. Although the mechanism is unknown, severe malnutrition may affect lung mechanics by altering the connective tissue, predisposing to pneumomediastinum.

METHOD

We describe a young male with anorexia nervosa and panic disorder who presented with symptoms similar to those of a panic attack and was diagnosed with spontaneous pneumomediastinum.

RESULTS

This case illustrates the importance of considering pneumomediastinum in the differential diagnosis of panic attack in patients with eating disorders.

DISCUSSION

Although spontaneous pneumomediastinum has a generally benign course, it must be differentiated from the potentially life-threatening secondary pneumomediastinum due to an esophageal tear.