title: Spontaneous pneumomediastinum, pneumoretroperitoneum, and cervicofacial subcutaneous emphysema after repeatedly and forcefully blowing into a bottle.
abstract: Spontaneous pneumomediastinum (SPM) is an uncommon, self-limiting condition associated with increased intra-thoracic pressure resulting in alveolar rupture. Search of the literature revealed no detailed case report about a 26-year-old psychiatric patient who repeatedly and forcefully blew air into a bottle for 5 days resulting in a combined condition of spontaneous pneumoretroperitoneum, pneumomediastinum, and cervicofacial subcutaneous emphysema. It is crucial to find a primary source and treat appropriately. Psychiatric patients may have psychotic behaviors mimicking Valsalva's maneuver that increases intra-thoracic pressure and causing SPM. Optimal medications should be given to control psychotic behaviors. Family members and caregivers should be explained about this unusual behavior so that they can prevent this rare condition.
authors.affiliation: Department of Internal Medicine, Interfaith Medical Center, Brooklyn, NY, USA; mglay2004@gmail.com.
authors.forename: Thein
authors.initials: T
authors.lastname: Swe
authors.affiliation: Department of Internal Medicine, Interfaith Medical Center, Brooklyn, NY, USA.
authors.forename: Akari Thein
authors.initials: AT
authors.lastname: Naing
authors.affiliation: Division of Pulmonary Medicine, Interfaith Medical Center, Brooklyn, NY, USA.
authors.forename: Antony
authors.initials: A
authors.lastname: Lixon
authors.affiliation: Division of Pulmonary Medicine, Interfaith Medical Center, Brooklyn, NY, USA.
authors.forename: Joseph
authors.initials: J
authors.lastname: Quist
keywords: blowing bottle; pneumomediastinum; pneumoretroperitoneum; subcutaneous emphysema; valsalva maneuver