{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,28]],"date-time":"2025-11-28T11:57:08Z","timestamp":1764331028390},"reference-count":14,"publisher":"Oxford University Press (OUP)","issue":"3-4","license":[{"start":{"date-parts":[[2019,9,27]],"date-time":"2019-09-27T00:00:00Z","timestamp":1569542400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,3,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>We report an unusual case of extensive subcutaneous emphysema, pneumomediastinum, and pneumopericardium identified in an otherwise healthy U.S. Marine who was enrolled in the Marine Corps School of Infantry. His training regimen included prolonged periods of yelling and elevation changes during sustained hiking through hilly terrain. The patient presented to the Fast Track with normal vital signs but complained of dyspnea, cough, and subjective fevers. Although he lacked a history of trauma, he was found to have pneumopericardium, pneumomediastinum, and subcutaneous emphysema without pneumothorax. He was admitted to the general surgery service for observation and was ultimately released back to his unit after 24\u00a0hours. To our knowledge, pneumopericardium has never been attributed to persistent yelling in the setting of a lower respiratory tract infection and should be considered in the differential of atraumatic chest symptomatology in otherwise healthy military service members.<\/jats:p>","DOI":"10.1093\/milmed\/usz191","type":"journal-article","created":{"date-parts":[[2019,9,27]],"date-time":"2019-09-27T11:41:48Z","timestamp":1569584508000},"page":"e518-e521","source":"Crossref","is-referenced-by-count":3,"title":["Spontaneous Pneumopericardium in a U.S. Marine: Do not Lose Heart"],"prefix":"10.1093","volume":"185","author":[{"given":"David","family":"Sherrier","sequence":"first","affiliation":[{"name":"Department of Family Medicine, Naval Hospital Camp Pendleton, 200 Mercy Circle, Oceanside, CA 92055"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Radhames E","family":"Lizardo","sequence":"first","affiliation":[{"name":"Department of Surgery, Naval Hospital Camp Pendleton, 200 Mercy Circle, Oceanside, CA 92055"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2019,9,27]]},"reference":[{"issue":"6","key":"2020040711151945000_ref1","doi-asserted-by":"publisher","first-page":"511","DOI":"10.1016\/S0003-4975(10)61146-0","article-title":"Pneumopericardium resulting in cardiac tamponade","volume":"37","author":"Cummings","year":"1984"},{"issue":"5","key":"2020040711151945000_ref2","doi-asserted-by":"publisher","first-page":"852","DOI":"10.1016\/j.ejcts.2004.01.042","article-title":"Current assessment and management of spontaneous pneumomediastinum: experience in 24 adult patients","volume":"25","author":"Koullias","year":"2004"},{"key":"2020040711151945000_ref3","doi-asserted-by":"publisher","DOI":"10.1136\/bcr-2018-226318","article-title":"Chest pain following permanent pacemaker insertion \u2026 a case of pneumopericardium due to atrial lead perforation","author":"Aktaa","year":"2018"},{"key":"2020040711151945000_ref4","doi-asserted-by":"publisher","first-page":"99","DOI":"10.4103\/aca.ACA_37_17","article-title":"Pneumopericardium after minimally invasive atrial septal defect closure YR - 2018\/1\/1","volume":"21","author":"Lamba","year":"2018"},{"key":"2020040711151945000_ref5","first-page":"1077","article-title":"The cardiac halo: pneumopericardium revisited","author":"Patial","year":"2015"},{"issue":"5","key":"2020040711151945000_ref6","doi-asserted-by":"publisher","first-page":"1713","DOI":"10.1016\/j.athoracsur.2010.01.086","article-title":"Tension pneumopericardium after blunt thoracic trauma","volume":"90","author":"O\u2019Connor","year":"2010"},{"issue":"12","key":"2020040711151945000_ref7","doi-asserted-by":"publisher","first-page":"5239","DOI":"10.21037\/jtd.2017.10.149","article-title":"Does oxygen therapy increase the resolution rate of primary spontaneous pneumothorax?","volume":"9","author":"Park","year":"2017"},{"key":"2020040711151945000_ref8","doi-asserted-by":"publisher","DOI":"10.1136\/bcr.02.2010.2765","article-title":"Spontaneous pneumomediastinum and subcutaneous emphysema in systemic lupus erythematosus","author":"Ahmed","year":"2010"},{"issue":"9","key":"2020040711151945000_ref9","doi-asserted-by":"publisher","first-page":"1329","DOI":"10.1016\/j.rmed.2008.03.023","article-title":"Management of spontaneous pneumomediastinum based on clinical experience of 25 cases","volume":"102","author":"Takada","year":"2008"},{"key":"2020040711151945000_ref10","doi-asserted-by":"publisher","first-page":"9","DOI":"10.1007\/s00408-006-0002-7","article-title":"Lung","author":"Mondello","year":"2007"},{"issue":"9","key":"2020040711151945000_ref11","doi-asserted-by":"publisher","first-page":"528","DOI":"10.1016\/s1579-2129(06)60274-7","article-title":"Spontaneous pneumomediastinum: descriptive study of our experience with 36 cases","volume":"41","author":"Campillo-Soto","year":"2006"},{"issue":"6","key":"2020040711151945000_ref12","doi-asserted-by":"publisher","first-page":"759","DOI":"10.1007\/s11739-015-1229-1","article-title":"Spontaneous pneumomediastinum due to the Macklin effect: less is more","volume":"10","author":"Chassagnon","year":"2015"},{"issue":"4","key":"2020040711151945000_ref13","first-page":"288","article-title":"Malignant interstitial emphysema of the lungs and mediastinum as an important occult complication in many respiratory diseases and other conditions: an interpretation of the clinical literautre in the light of laboratory experiment","volume":"23","author":"Macklin","year":"1944"},{"issue":"11","key":"2020040711151945000_ref14","doi-asserted-by":"publisher","first-page":"1396","DOI":"10.7205\/milmed-d-12-00243","article-title":"Ooh-rah! 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