Supplementary Material for: Spontaneous Pneumomediastinum associated with Semaglutide Therapy: A Case Report

Abstract
Introduction:
The seemingly harmless side effects of semaglutide, such as vomiting, may rarely lead to serious complications. This case is unique in highlighting spontaneous pneumomediastinum (SPM) as a potential consequence of unsupervised semaglutide use, adding new insight to the literature on the safety profile of weight-loss medications.
Case Presentation:
We report the case of a 26-year-old woman who developed SPM shortly after the self-administered use of semaglutide purchased online for weight loss. The patient presented with vomiting, chest and neck pain, and progressive facial swelling. Imaging revealed extensive pneumomediastinum and cervicothoracic emphysema. Esophago-gastro-duodenoscopy was performed to rule out oesophageal perforation and showed no abnormalities. The patient was managed conservatively with spontaneous recovery.
Conclusion:
This case highlights the importance of distinguishing SPM from life-threatening conditions such as Boerhaave’s syndrome, and raises concerns regarding the unsupervised use of injectable weight-loss medications, emphasising the need for patient education and careful monitoring.