Abstract：
:Spontaneous pneumomediastinum (SPM) with associated subcutaneous emphysema is an uncommon and generally benign condition. We describe an occurrence of SPM that occurred from yelling in a U.S. Marine Corps Drill Instructor. The patient describes yelling at Marine recruits the day prior when he felt a pop "behind his nose." Upon arrival to the Emergency Department, the patient was normotensive, afebrile, and maintaining an oxygen saturation of 100% on room air. Chest films demonstrated pneumomediastinum and subcutaneous emphysema. A computed tomography scan of the head, neck, and chest showed pneumomediastinum and air tracking along the trachea, great vessels, and esophagus with subcutaneous emphysema and without pneumothorax or esophageal injury. The patient was admitted to internal medicine and discharged after 24 hours of observation with improved pain and decreased subcutaneous air. Pneumomediastinum is commonly associated with blunt and penetrating trauma, infection, and esophageal rupture. Life-threatening complications include tension pneumomediastinum/pneumothorax and rupture of intrathoracic viscus. Treatment includes rest, oxygen therapy, and analgesia. SPM has never been described as a result of a yelling, and persistent yelling is common for a drill instructor. SPM can present in primary care and operational settings, and recognition and prompt treatment is crucial for these patients.
journal_name
Mil Medjournal_title
Military medicineauthors
Singla M,Potocko J,Sanstead J,Pepper Pdoi
10.7205/milmed-d-12-00243subject
Has Abstractpub_date
2012-11-01 00:00:00pages
1396-8issue
11eissn
0026-4075issn
1930-613Xjournal_volume
177pub_type
杂志文章abstract：:At the direction of the Army Surgeon General, the Army behavioral health consultants in psychiatry, psychology, and social work assembled in Washington, DC immediately after the September 11, 2001 attack to plan and implement a proactive behavioral health response to the Pentagon attack. The goal was to minimize the s...
journal_title：Military medicine
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journal_title：Military medicine
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journal_title：Military medicine
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journal_title：Military medicine
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doi：
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journal_title：Military medicine
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doi：
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doi：
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doi：
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journal_title：Military medicine
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doi：
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doi：
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