Pneumomediastinum is a rare complica-tion of increased intrathoracic pressure. It is more likely to occur in individuals with nutritional deficiencies. Pneumomediastinum has been reported in some individuals with anorexia nervosa.
Recurrent subcutaneous emphysema is probably secondary to recurrent pneumomediastinum in a woman with bulimia nervosa.
It is believed that increased intrathoracic pressure and nutritional deficiency associated with repeated induced vomiting contributed to this complication. This is the only case of recurrent subcutaneous emphysema. While in this case, and in most cases, the course was benign with eventual reabsorption of the subcutaneous air, pneumomediastinum can be a life-threatening complication of bulimia nervosa. © 2012 by Wiley Periodicals, Inc. (Int J Eat Disord 2012;)