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 pneumoretroperitone... https://www.roneverhart.com/Jacksonville-Lever-with-Round-Rose-Omnia-943-00/