Noisy belching in front of other people, often considered to be an impolite manner, may not be as harmless as it seems. We report on a patient who had spontaneous pneumomediastinum after intentional induction of noisy belching by rapid excessive intake of carbonated drinks (imitating the game played in a popular local television program “The Super Trio Continues…”). The clinical features, investigations and management of spontaneous pneumomediastinum are discussed.
ChungC.H.X-ray quiz: a young man with chest pain.Hong Kong J Emerg Med2004; 11(2): 91–3.
7.
Lopez-PelaezM.F., RoldanJ., MateoS.Cervical emphysema, pneumomediastinum, and pneumothorax following self-induced oral injury: report of four cases and review of the literature.Chest2001; 120(1): 306–9.
8.
MeronG., ToblerK., KurkciyanI.Self-induced subcutaneous emphysema and pneumomediastinum.Chest2002; 122(1): 386.
9.
de la Fuente AguadoJ., RomanF., HernaezJ.M., ProvencioM., de LetonaJ.M.Pneumomediastinum after belching.Lancet1990; 336(8727): 1390.
BejvanS.M., GodwinJ.D.Pneumomediastinum: old signs and new signs.AJR Am J Roentgenol1996; 166(5): 1041–8.
13.
LevinB.The continuous diaphragm sign. A newly-recognized sign of pneumomediastinum.Clin Radiol1973; 24(3): 337–8.
14.
JougonJ.B., BallesterM., DelcambreF., Mac BrideT., DromerC.E., VellyJ.F.Assessment of spontaneous pneumomediastinum: experience with 12 patients.Ann Thorac Surg2003; 75(6): 1711–4.
15.
KanekiT., KuboK., KawashimaA., KoizumiT., SekiguchiM., SoneS.Spontaneous pneumomediastinum in 33 patients: yield of chest computed tomography for the diagnosis of the mild type.Respiration2000; 67(4): 408–11.
16.
ChapdelaineJ., BeaunoyerM., DaigneaultP., BerubeD., ButterA., OuimetA.Spontaneous pneumomediastinum: are we overinvestigating?J Pediatr Surg2004; 39(5): 681–4.
17.
SmithB.A., FergusonD.B.Disposition of spontaneous pneumomediastinum.Am J Emerg Med1991; 9(3): 256–9.
18.
SpronkP.E., BeishuizenA., van der HovenB.Belching and the development of Boerhaave's syndrome.Intensive Care Med2001; 27(1): 330.
19.
HowtonJ.C.Boerhaave's syndrome in a healthy adolescent male presenting with pneumomediastinum.Ann Emerg Med2004; 43(6): 785.
20.
FanK.P., KunW.M., TungW.K.Spontaneous pneumomediastinum - an uncommon disease presenting as a common complaint.Hong Kong J Emerg Med2000; 7(1): 42–5.